నైరూప్య

Targeted therapy of glioblastomas: A 5 year view

Ryad Djedid, Robert Kiss and Florence Lefranc

The treatment of glioblastomas requires a multidisciplinary approach that takes the presently incurable nature of the disease into consideration. Treatments are multimodal and include surgery, radiotherapy and chemotherapy. Current recommendations are that patients with glioblastoma should undergo maximum surgical resection followed by concurrent radiation and chemotherapy with the novel alkylating drug temozolomide, followed subsequently by additional adjuvant temozolomide for a period of up to 6 months. We describe here the major signaling pathways that can be constitutively activated in migrating glioma cells, and which render these cells resistant to pro-apoptotic insults such as conventional chemotherapies. In light of this resistance, we therefore describe the molecular therapies and local drug delivery systems that could be used to complement conventional treatments. We have reviewed more than 400 ongoing clinical trials with respect to these new targeted therapy approaches alone or in combination for glioblastoma therapy.