A Critical Overview of Targeted Therapies for Glioblastoma
- 1Jain PharmaBiotech (Switzerland), Switzerland
Over the past century, treatment of malignant tumors of the brain has remained a challenge. Refinements in neurosurgical techniques, discovery of powerful chemotherapeutic agents, advances in radiotherapy, applications of biotechnology, and improvements in methods of targeted delivery have led to some extension of length of survival of glioblastoma patients. Refinements in surgery are mentioned because most of the patients with glioblastoma undergo surgery and many of the other innovative therapies are combined with surgery. However, cure of glioblastoma has remained elusive because it requires complete destruction of the tumor. Radical surgical ablation is not possible in the brain and even a small residual tumor leads to rapid recurrence that eventually kills the patient. Delivery to the brain is limited by the blood-brain barrier (BBB) and mere opening of the barrier still limits systemic chemotherapy as higher concentration in the normal brain can be neurotoxic. Therefore, targeted therapy is required for glioblastomas.
I will present a classification and critical evaluation of various methods of targeted therapies for glioblastoma including: (1) novel methods for targeted delivery of chemotherapy; (2) strategies for delivery through BBB and blood-tumor barriers: (3) innovations in radiotherapy for selective destruction of tumor; (4) techniques for local destruction of tumor; (5) tumor growth inhibitors; (6) immunotherapy; and (7) cell/gene therapies.
Suggestions for improvements in glioblastoma therapy include: (1) controlled targeted delivery of anticancer therapy to glioblastoma through the BBB using nanoparticles and monoclonal antibodies; (2) direct introduction of genetically modified bacteria that selectively destroy cancer cells but spare the normal brain into the remaining tumor after resection; (3) use of better animal models for preclinical testing; and (4) personalized/precision medicine approaches to therapy in clinical trials and translation into practice of neurosurgery and neurooncology. Advances in these techniques suggest optimism for the future management of glioblastoma.
Keywords: targeted therapies, Glioblastoma, novel drug targets, chemotherapy, oncology
Received: 06 Aug 2018;
Accepted: 10 Sep 2018.
Edited by:Shiv K. Gupta, Mayo Clinic, United States
Reviewed by:Paul B. Fisher, Virginia Commonwealth University, United States
Antonio Rozzi, INI, Istituto Neurotraumatologico Italiano, Italy
Copyright: © 2018 Jain. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Kewal K. Jain, Jain PharmaBiotech (Switzerland), Basel, 4057, Switzerland, firstname.lastname@example.org