Current therapeutic options for glioblastoma and future perspectives

INTRODUCTION: Glioblastoma is a malignant primary brain tumor that affects approximately 250,000 new patients per year worldwide. It is among the most difficult cancers to treat, and 5-year survival rates remain low. Standard therapies for glioblastoma include surgical resection, radiation therapy and systemic chemotherapy. AREAS COVERED: We conducted a search of the literature on therapeutic options for glioblastoma on Pubmed. We also searched abstracts from the American Society of Clinical Oncology, Society for Neuro-Oncology, European Association of Neuro-Oncology and American Association for Cancer Research. We also searched the U.S. National Library of Medicine clinical trials database. We discuss therapeutic options for newly diagnosed glioblastoma, mainly temozolomide, lomustine and tumor treating fields (TTF). Lastly, we discuss therapeutics for recurrent glioblastomas and agents under investigation in clinical trials. EXPERT OPINION: Enrollment in clinical trials is encouraged for both newly diagnosed and recurrent glioblastoma patients. The standard post-operative treatment for newly diagnosed glioblastoma patients is a combination of radiotherapy and temozolomide. TTF devices can be used in conjunction with temozolomide. Available standard therapies for recurrent glioblastoma include nitrosureas, bevacizumab and temozolomide rechallenge, as well as TTF devices. Agents that are being evaluated in clinical trials include novel targeted therapies, novel chemotherapies, and immunotherapies.