Glioblastoma Therapy in the Age of Molecular Medicine

Trends Cancer. 2019 Jan;5(1):46-65. doi: 10.1016/j.trecan.2018.11.002. Epub 2018 Dec 7.

Abstract

Glioblastoma (GBM) is the most common and fatal primary malignant brain tumor. Despite advances in the understanding of the biology of gliomas, little has changed in the treatment of these tumors in the past decade. Phase III clinical trials showed no benefit for the use of bevacizumab in newly diagnosed patients, leading to a renewed search for new antiangiogenic drugs, as well as immunotherapeutic approaches, including checkpoint inhibitors, chimeric antigen receptor T cells, and intracerebral CpG-oligodeoxynucleotides. The emerging role of infiltrating microglia and macrophages, and of metabolic alterations, is also being taken into account in preclinical research and drug development. In this review, we discuss progress in the search for new therapeutic strategies, particularly approaches focusing on the tumor microenvironment.

Keywords: angiogenesis; cancer metabolism; cancer therapy; glioblastoma; immunotherapy; microglia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / pharmacology
  • Angiogenesis Inhibitors / therapeutic use
  • Animals
  • Antineoplastic Agents, Immunological / pharmacology
  • Antineoplastic Agents, Immunological / therapeutic use
  • Biomarkers, Tumor
  • Brain Neoplasms / etiology
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Energy Metabolism / drug effects
  • Genetic Therapy
  • Glioblastoma / etiology
  • Glioblastoma / metabolism
  • Glioblastoma / pathology
  • Glioblastoma / therapy*
  • Humans
  • Immunotherapy, Adoptive / methods
  • Molecular Targeted Therapy* / methods
  • Tumor Microenvironment / drug effects
  • Tumor Microenvironment / genetics
  • Tumor Microenvironment / immunology

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents, Immunological
  • Biomarkers, Tumor