Understanding the Current and Evolving Therapeutic Drug Regimes for Glioblastoma: A Literature Review

Gliomas being the commonest of all primary brain tumors have been a subject of countless research over the last three decades. Despite the current standard treatment for glioma which consists of a triad comprising of initially aggressive surgery followed by radiotherapy and the chemotherapeutic drug temozolomide, the outcome of glioma patients remains dismal. The median overall survival time for patients with the most aggressive subtype is only 15 months. With oncological advancement and development of newer drugs, new treatment delivery methods are gaining approval especially in recurrent and stage III and IV gliomas. We reviewed the PUBMED/ Medline database for current therapeutic concepts along with the new drugs under consideration for the treatment of gliomas. The treatment options include drugs from various classes with diverse mechanisms of action including VEGF inhibitors, alkaloid derivatives, tyrosine kinase inhibitors, PI3K/AKT and mTOR inhibitors and BCNU. The aforementioned drugs exhibited better outcomes and progression free survival as compared to placebo. A comprehensive review of currently recommended drugs regimes is also discussed. We conclude that there is prospect for newer therapeutic drugs to become first line treatment particularly for rGBM in the future, however, TMZ still remains the drug of choice till today.