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Glioblastoma Multiforme (GBM)

Glioblastoma Multiforme (GBM)

  • June 18, 2023
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Introduction

Glioblastoma Multiforme (GBM) is a malignant brain tumor that arises from glial cells, specifically astrocytes. It is the most common and aggressive form of primary brain tumor in adults. This article explores various aspects of GBM, including its epidemiology, etiology, pathogenesis, clinical findings, and treatment options.

GBM Epidemiology

GBM has an overall incidence rate of approximately 3 per 100,000 people worldwide. It predominantly affects adults, with a peak incidence between the ages of 45 and 70 years. It is more common in males than females. The incidence of GBM tends to increase with age, and it is more prevalent in Caucasians compared to other racial/ethnic groups.

Etiology

The exact cause of GBM remains unclear. However, certain risk factors and genetic predispositions have been associated with its development. These risk factors include a history of ionizing radiation exposure, such as previous radiotherapy treatment for other brain tumors, as well as certain genetic disorders such as neurofibromatosis type 1 (NF1) and Li-Fraumeni syndrome.

Pathogenesis

The pathogenesis of GBM involves complex molecular alterations that lead to uncontrolled cell growth and invasion within the brain. Genetic mutations and chromosomal abnormalities play a significant role in the development and progression of GBM. Mutations in genes such as epidermal growth factor receptor (EGFR), TP53, phosphatase and tensin homolog (PTEN), and isocitrate dehydrogenase (IDH) have been implicated in the pathogenesis of GBM.

Clinical Findings

GBM presents with a wide range of clinical manifestations that are often related to the location of the tumor within the brain. Common symptoms include persistent headaches, seizures, progressive neurological deficits (such as weakness or changes in speech or vision), and cognitive impairment. Imaging techniques, such as magnetic resonance imaging (MRI), are crucial for diagnosing and staging GBM.

Treatment

The management of GBM typically involves a multimodal approach, including surgery, radiation therapy, and chemotherapy. Surgical resection aims to remove as much of the tumor as possible, followed by radiation therapy to target any remaining tumor cells. Chemotherapy, often using the drug temozolomide, is administered concurrently with radiation and continued afterward as adjuvant therapy. Other treatment options being explored include targeted therapies, immunotherapy, and experimental approaches like gene therapy.

Conclusion

Glioblastoma Multiforme is a highly aggressive brain tumor with a poor prognosis. Despite advances in treatment, the overall survival rate remains low. Efforts are ongoing to better understand the molecular mechanisms underlying GBM, identify novel therapeutic targets, and develop more effective treatment strategies to improve patient outcomes.

References

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  2. Ostrom, Q. T., Gittleman, H., Liao, P., Vecchione-Koval, T., Wolinsky, Y., Kruchko, C., & Barnholtz-Sloan, J. S. (2017). CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014. Neuro-Oncology, 19(suppl_5), v1-v88.
  3. Ohgaki, H., & Kleihues, P. (2007). Genetic pathways to primary and secondary glioblastoma. The American Journal of Pathology, 170(5), 1445-1453.
  4. Louis, D. N., Perry, A., Reifenberger, G., von Deimling, A., Figarella-Branger, D., Cavenee, W. K., … & Ellison, D. W. (2016). The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathologica, 131(6), 803-820.
  5. Weller, M., van den Bent, M., Tonn, J. C., Stupp, R., Preusser, M., Cohen-Jonathan-Moyal, E., … & Wick, W. (2017). European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas. The Lancet Oncology, 18(6), e315-e329.
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