[Association of radiotherapy and chemotherapy-targeted therapies in glioblastomas]

Despite recent and significant progress, the prognosis of glioblastoma remains extremely poor. Concomitant chemoradiotherapy with temozolomide is now the standard of care for newly diagnosed glioblastoma. This treatment is well-tolerated and results in improvement of overall survival and dramatic increase of long term survivor rate, especially in good performance status patients. Besides, this benefit is particularly marked in patients with MGMT (methylguanine methyltransferase) methylated tumor, suggesting a growing place of molecular markers in pattern of care of such patients. At recurrence, the combination of bevacizumab (anti-VEGF) with irinotecan has shown surprising high response rates in a phase II trial for recurrent malignant gliomas. Many other targeted therapies are currently under investigation, alone or in association, at recurrence or up-front and during radiotherapy. For this reason, in the future a more precise understanding of gliomagenesis is needed for a better molecular stratification of patients.