Glioblastoma multiforme

Synonyms

3

Overview

Glioblastoma multiforme (GBM), is the most common and most aggressive malignant primary brain tumor. It involves glial cells and accounting for 52% of all brain tissue tumor cases and 20% of all tumors inside the skull. Glioblastomas are often very aggressive and grow into surrounding brain tissue. Signs and symptoms, such as headache, nausea, vomiting and/or drowsiness, may develop when the tumor begins to put excess pressure on the brain. Affected people may also experience other features depending on the size and location of the tumor. In most cases, the exact underlying cause is unknown; however, they can rarely occur in people with certain genetic syndromes such as neurofibromatosis type 1, Turcot syndrome and Li Fraumeni syndrome. There is currently no cure for glioblastoma. Treatment is palliative and may include surgery, radiation therapy and/or chemotherapy.

Symptoms

Signs and symptoms of glioblastoma vary depending on the size and location of the tumor but may include:

  • Headache
  • Nausea and vomiting
  • Drowsiness
  • Changes in personality
  • Weakness on one side of the body
  • Memory loss
  • Speech difficulty
  • Changes in vision
  • Seizures

Causes

In most cases, the exact underlying cause of glioblastoma is unknown. In rare cases, they can occur in people with certain genetic syndromes such as neurofibromatosis type 1, Turcot syndrome and Li Fraumeni syndrome. In these cases, affected people usually have other characteristic features of the condition that are all caused by mutations in a specific gene.

Prevention

As the causes of GBM are unknown, there are no preventive measures. Most glioblastomas are not inherited. They usually occur sporadically in people with no family history of tumors. 

Diagnosis

Genetic testing is not available for many people with glioblastoma since most of these tumors occur sporadically (by chance) and are not caused by a genetic mutation.

However, genetic testing is an option for people with an inherited condition that predisposes to glioblastoma such as neurofibromatosis type 1, Turcot syndrome and Li Fraumeni syndrome. Carrier testing for at-risk relatives and prenatal testing are possible if the disease-causing mutation in the family is known.

Glioblastoma is typically diagnosed based on a physical exam that identifies characteristic symptoms and various imaging studies such as computed tomography (CT) and/or magnetic resonance imaging (MRI). A CT scan is an imaging method that uses x-rays to create pictures of cross-sections of the body, while an MRI scan uses powerful magnets and radio waves to create pictures of the brain and surrounding nerve tissues. These imaging studies will also provide information regarding the size of the tumor and which parts of the brain are affected. Surgical removal of the tumor or a small biopsy may confirm the diagnosis.[

Prognosis

The long-term outlook (prognosis) for people with glioblastoma is poor. There is currently no cure and despite treatment, many affected people live less than a year after the initial diagnosis. However, life expectancy following diagnosis depends on many factors. Younger age; higher Karnofsky performance (a standard measure of the ability of patients with cancer to perform daily tasks) score at diagnosis; and treatment with chemotherapy and radiation therapy are all associated with a better prognosis. The extent to which the tumor is able to be removed also appears to influence the outcome.

Treatment

Unfortunately, there is no cure for glioblastoma. Treatment is palliative and may include surgery, radiation therapy and/or chemotherapy. The best treatment options for each person depend on many factors including the size and location of the tumor; the extent to which the tumor has grown into the surrounding normal brain tissues; and the affected person's age and overall health. Glioblastoma is often treated with surgery initially to remove as much of the tumor as possible. In most cases, it is not possible to remove the entire tumor so additional treatment with radiation therapy and/or chemotherapy is necessary. In elderly people or people in whom surgery is not an option, radiation therapy and/or chemotherapy may be used.

Approved therapies:

Polifeprosan 20 with carmustine (Gliadel) - FDA-approved indication: As an adjunct to surgery to prolong survival in patients with recurrent glioblastoma multiforme for whom surgical resection is indicated 

Resources

Refer to Research Publications.