New Treatments for Malignant Gliomas: Careful Evaluation and Cautious Optimism Required

  title={New Treatments for Malignant Gliomas: Careful Evaluation and Cautious Optimism Required},
  author={Mark R. Gilbert},
  journal={Annals of Internal Medicine},
  • M. Gilbert
  • Published 7 March 2006
  • Medicine
  • Annals of Internal Medicine
The treatment of patients with glioblastoma is a showcase for improved technology in many disciplines of medicine. Imaging technology has improved substantially, leading to more accurate and rapid diagnosis; better anatomic localization, which leads to improvements in neurosurgical results; and earlier detection of recurrent or relapsing disease. Surgical techniques have improved with better tumor delineation, which results in a higher percentage of patients having what seems to be complete… 

Molecular strategies for the treatment of malignant glioma—genes, viruses, and vaccines

Molecular approaches may not lead to the discovery of a “magic bullet” for these aggressive tumors, but they may ultimately prove synergistic with more conventional approaches and lead to a broadening of the multimodal approach that is the current standard of care.

The outcomes of concomitant radiation plus temozolomide followed by adjuvant temozolomide for newly diagnosed high grade gliomas: the preliminary results of single center prospective study.

The addition of TMZ to RT followed by adjuvant TMZ was well tolerated, and has shown promising activity in the treatment of newly diagnosed HGG.

Prognostic factors and treatment outcome in glial brain tumors; data from the third neuro-oncology scientific club's input forum, 2013, Mashhad, Iran.

Clinical outcome, survival data and prognostic factors in adult and pediatric Gliomas over the past several years in Mashhad, the association between methylguanine methyl transferase (MGMT) methylation status (determined by MSQP or methylation specific quantitative polymerase chain reaction) where among the main studies outlined during this event.

NHERF-1: modulator of glioblastoma cell migration and invasion.

Results provide the first evidence for NHERF-1 as a participant in the highly invasive phenotype of malignant gliomas and implicate NHERFs as a possible therapeutic target for treatment of GBM.

Repurposing Drugs in Oncology (ReDO)—chloroquine and hydroxychloroquine as anti-cancer agents

Preclinical studies support CQ and HCQ use in anti- cancer therapy, especially in combination with conventional anti-cancer treatments since they are able to sensitise tumour cells to a variety of drugs, potentiating the therapeutic activity.

Clinical Evidence and Radiobiological Background of Particle Radiation Therapy

Charged particle therapy compared to the conventional radiotherapy offers many advantages, with the possibility to deposit the energy more precisely to the tumour leading to a higher tumour local control, a lower probability to damage the surrounding healthy tissue and a lower risk of complications.

NHERF1 Between Promises and Hopes: Overview on Cancer and Prospective Openings1

Temozolomide-Mediated Apoptotic Death Is Improved by Thymoquinone in U87MG Cell Line

Investigation of the effect of temozolomide and thymoquinone combination on apoptotic pathway of human glioblastoma multiforme cell line found it can be a good strategy for treatment of gliOBlastoma.

H‐bonding and stacking interactions between chloroquine and temozolomide

The interactions between temozolomide and chloroquine were examined via Dispersion-Corrected Density Functional Theory and MP2 methods. Chloroquine was considered in both its lowest energy structure



Neuro-oncology clinical trials: promise and pitfalls.

  • M. Gilbert
  • Medicine
    Annals of oncology : official journal of the European Society for Medical Oncology
  • 2001
Three manuscripts in this journal describe studies using the chemotherapy agent, temozolomide, for recurrent malignant gliomas and recurrent brain metastases, and the findings are not directly comparable to other phase II studies.

Adding Chloroquine to Conventional Treatment for Glioblastoma Multiforme

Chloroquine, in conjunction with other treatments, may prolong survival in patients with glioblastoma multiforme by administering chloroquine in addition to surgery and to the standard courses of radiotherapy and chemotherapy.

Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials.

This study of malignant glioma patients used a non-parametric statistical technique to examine the associations of both pretreatment patient and tumor characteristics and treatment-related variables with survival duration and permits examination of the interaction between prognostic variables not possible with other forms of multivariate analysis.

Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery.

It is suggested that it is best to use radiotherapy in the post-surgical treatment of malignant glioma and to continue the search for an effective chemotherapeutic regimen to use in addition to radiotherapy.

A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival.

Gross-total tumor resection is associated with longer survival in patients with GBM, especially when other predictive variables are favorable.

Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.

The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity.

Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial.

An analysis of prognostic factors indicates that the initial performance status, age, the use of only a surgical biopsy, parietal location, the presence of seizures, or the involvement of cranial nerves II, III, IV, and VI are all of significance.

A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma.

This study confirms that local chemotherapy with BCNU wafers is well tolerated and offers a survival benefit to patients with newly diagnosed malignant glioma.

Phase II study of continuous infusion carmustine and cisplatin followed by cranial irradiation in adults with newly diagnosed high-grade astrocytoma.

This chemotherapy regimen appears to have significant activity and may prolong survival in adults with newly diagnosed high-grade astrocytoma.