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Current FDA-Approved Therapies for High-Grade Malignant Gliomas

The standard of care (SOC) for high-grade gliomas (HGG) is maximally safe surgical resection, followed by concurrent radiation therapy (RT) and temozolomide (TMZ) for 6 weeks, then adjuvant TMZ for 6 months. Before this SOC was established, glioblastoma (GBM) patients typically lived for less than o...

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Autores principales: Fisher, Jacob P., Adamson, David C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004675/
https://www.ncbi.nlm.nih.gov/pubmed/33810154
http://dx.doi.org/10.3390/biomedicines9030324
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author Fisher, Jacob P.
Adamson, David C.
author_facet Fisher, Jacob P.
Adamson, David C.
author_sort Fisher, Jacob P.
collection PubMed
description The standard of care (SOC) for high-grade gliomas (HGG) is maximally safe surgical resection, followed by concurrent radiation therapy (RT) and temozolomide (TMZ) for 6 weeks, then adjuvant TMZ for 6 months. Before this SOC was established, glioblastoma (GBM) patients typically lived for less than one year after diagnosis, and no adjuvant chemotherapy had demonstrated significant survival benefits compared with radiation alone. In 2005, the Stupp et al. randomized controlled trial (RCT) on newly diagnosed GBM patients concluded that RT plus TMZ compared to RT alone significantly improved overall survival (OS) (14.6 vs. 12.1 months) and progression-free survival (PFS) at 6 months (PFS6) (53.9% vs. 36.4%). Outside of TMZ, there are four drugs and one device FDA-approved for the treatment of HGGs: lomustine, intravenous carmustine, carmustine wafer implants, bevacizumab (BVZ), and tumor treatment fields (TTFields). These treatments are now mainly used to treat recurrent HGGs and symptoms. TTFields is the only treatment that has been shown to improve OS (20.5 vs. 15.6 months) and PFS6 (56% vs. 37%) in comparison to the current SOC. TTFields is the newest addition to this list of FDA-approved treatments, but has not been universally accepted yet as part of SOC.
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spelling pubmed-80046752021-03-29 Current FDA-Approved Therapies for High-Grade Malignant Gliomas Fisher, Jacob P. Adamson, David C. Biomedicines Review The standard of care (SOC) for high-grade gliomas (HGG) is maximally safe surgical resection, followed by concurrent radiation therapy (RT) and temozolomide (TMZ) for 6 weeks, then adjuvant TMZ for 6 months. Before this SOC was established, glioblastoma (GBM) patients typically lived for less than one year after diagnosis, and no adjuvant chemotherapy had demonstrated significant survival benefits compared with radiation alone. In 2005, the Stupp et al. randomized controlled trial (RCT) on newly diagnosed GBM patients concluded that RT plus TMZ compared to RT alone significantly improved overall survival (OS) (14.6 vs. 12.1 months) and progression-free survival (PFS) at 6 months (PFS6) (53.9% vs. 36.4%). Outside of TMZ, there are four drugs and one device FDA-approved for the treatment of HGGs: lomustine, intravenous carmustine, carmustine wafer implants, bevacizumab (BVZ), and tumor treatment fields (TTFields). These treatments are now mainly used to treat recurrent HGGs and symptoms. TTFields is the only treatment that has been shown to improve OS (20.5 vs. 15.6 months) and PFS6 (56% vs. 37%) in comparison to the current SOC. TTFields is the newest addition to this list of FDA-approved treatments, but has not been universally accepted yet as part of SOC. MDPI 2021-03-22 /pmc/articles/PMC8004675/ /pubmed/33810154 http://dx.doi.org/10.3390/biomedicines9030324 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Review
Fisher, Jacob P.
Adamson, David C.
Current FDA-Approved Therapies for High-Grade Malignant Gliomas
title Current FDA-Approved Therapies for High-Grade Malignant Gliomas
title_full Current FDA-Approved Therapies for High-Grade Malignant Gliomas
title_fullStr Current FDA-Approved Therapies for High-Grade Malignant Gliomas
title_full_unstemmed Current FDA-Approved Therapies for High-Grade Malignant Gliomas
title_short Current FDA-Approved Therapies for High-Grade Malignant Gliomas
title_sort current fda-approved therapies for high-grade malignant gliomas
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004675/
https://www.ncbi.nlm.nih.gov/pubmed/33810154
http://dx.doi.org/10.3390/biomedicines9030324
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