Therapy for Glioblastoma – is it working?

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As of July 2018, there were 759 ongoing or projected clinical trials for glioblastoma. • Drug therapies appear compromised by the need to combat tumour heterogeneity. • Immunotherapy approaches targeting multiple tumour antigens are showing promise in the clinic. • Improved understanding of glioblastoma tumour biology is paving the way for better drugs and integrated treatment strategies.

 Glioblastoma (GBM) remains one of the most intransigent of cancers, with a median overall survival of only 15 months after diagnosis. Drug treatments have largely proven ineffective; it is thought that this is related to the heterogeneous nature and plasticity of GBM-initiating stem cell lineages. Although many combination drug therapies are being positioned to address tumour heterogeneity, the most promising therapeutic approaches for GBM to date appear to be those targeting GBM by vaccination or antibody- and cell-based immunotherapy. We review the most recent clinical trials for GBM and discuss the role of adaptive clinical trials in developing personalised treatment strategies to address intra- and inter-tumoral heterogeneity.

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