GLIOBLASTOMA MULTIFORME: A REVIEW OF ITS PATHOGENESIS AND TREATMENT

Abstract

Glioblastoma multiforme (WHO grade IV astrocytoma) are tumours that arise from astrocytes: the star-shaped cells that make up the “glue-like or supportive tissue of the brain. It is the most malignant types of brain tumour in adults, representing a highly heterogeneous group of neoplasms which are among the most aggressive and challenging cancers to treat. The term GBM was first introduced by Harvey Cushing in 1926 based on the indication that the tumour originates from primitive precursors of glial cells and the highly variable appearance because of the presence of necrosis, hemorrhage and cysts. Despite various modern therapies against GBM, it is still a deadly disease with extremely poor prognosis and has a median survival of 7–15 months from the time of diagnosis. Over 90% of diagnosed glioblastoma multiforme cases are primary gliomas (de novo), which arise from normal glial cells through multistep oncogenesis. The remaining 10% are secondary gliomas develop through the progression from lower grade tumours. Hallmarks of this aggressive cancer include extensive infiltration and strong vascular proliferation into the surrounding brain parenchyma. New approaches to study glioblastoma multiforme and to design optimized therapies are greatly required to address the overwhelmingly poor treatment results for patients currently diagnosed with glioblastoma. This review focuses on GBM epidemiology, etiology, pathogenesis, clinical findings and treatment. In addition, we will highlight recent developments in GBM drug discovery and delivery.