Overall Survival Outcome In Patients With New Treatment Approaches For Glioblastoma Multiforme In Randomized Controlled Trials
María Castillo Vaca1, Marcos Flores Arreola1, Sergio Bermúdez Faz1, David Alejandro Chávez Castillo1, Eyra Montserrat Chávez Castillo1, Sergio Manuel Carrillo Rodríguez1, María Fernanda Estrada Posadas1, Thania Fabiola Estrada Ortega1, María Fernanda Rojas Martínez1, Raul Zamorano Serrano1
1Universidad Autónoma de San Luis Potosi, UASLP
Objective:
- Analyze and compare the current standard treatment for glioblastoma multiforme with new treatment approaches with an emphasis on overall survival in randomized controlled trials.
Background:
- Glioblastoma multiforme is the most common malignant brain tumor in adults, accounting for approximately 16% of all CNS neoplasms. The current standard treatment for glioblastoma consists of maximal surgical resection, radiotherapy and concomitant or adjuvant chemotherapy with temozolomide. While overall mortality remains high, the understanding of gene mutations and molecular mechanisms combined with clinical trials are opening new ways to approach this disease.
Design/Methods:
- The search in PUBMED/MEDLINE included the keywords: "Glioblastoma", " Temozolomide", resulting in 2,618 articles, the filter of the last 5 years was applied as well as randomized clinical trials, this yielded 37 results. A reading of the abstract and title was made.Referenced articles were also used. Finally, 12 articles were used. Subsequent analysis was performed with PRISMA.
Results:
- Among the new treatment approaches, the use of Tumor – treating fields (TTFields) plus temozolomide increases progression free survival and overall survival compared to standard of care, while therapies such as ipilimumab plus temozolomide and velipaprib did not show significant differences in overall survival, progression free survival rate did not improve compared to the use of radiotherapy and concomitant or adjuvant chemotherapia with temozolomide.
Conclusions:
To summarize up due to the high mortality associated with glioblastoma, a search for efficacy of alternative treatments is necessary. The effect of different treatment strategies on survival and other health outcomes remains largely unknown, although in treating fields (TTFields) there was a statistically significant increase in survival, it is an efficient and safe treatment that will increase the overall survival in this disease where recurrence and lethality are high and where the quality and lengthening of life become the central axis.