Endeavouring to improve glioblastoma multiforme patient prognosis – a literature review of biomarkers and novel therapeutic approaches

Glioblastoma Multiforme (GBM) patients typically deteriorate at a rapid rate, and survive an average of 15 months from diagnosis – despite clinical intervention with the current approach of maximal surgical resection and adjuvant chemoradiotherapy. Tumour recurrence and treatment resistance remain inevitable with this standard treatment protocol, and therefore, we must endeavour to investigate more efficacious alternatives which offer better patients better prognosis and quality of life. GBM is a highly heterogeneous tumour: both between the cells within the tumour itself, and between individual patients. This makes finding a single effective treatment regimen a significant challenge – with a simple, ‘one-size-fits-all’ approach proven to be inadequate. There is therefore great indication to: 1) identify tumour-specific genetic signatures; 2) determine suitable predictive and prognostic biomarkers; 3) develop treatment strategies with specific molecular targets; and 4) develop efficacious agents that have the ability to cross the blood-brain-barrier (BBB) - which impedes the delivery of chemotherapeutics to the tumour site. This review discusses novel therapeutic approaches (e.g. precision medicine, microRNAs, magnetic resonance-guided focused ultrasound (MRgFUS), immunotherapy, nanoparticles) which either improve intratumoral delivery of current chemotherapeutics, or act themselves as a more targeted agent – and therefore, may have the potential to improve the diagnostic burden faced by individuals with this devastating illness.