[The newest perspectives on the treatment of glioblastoma multiforme]

Glioblastoma multiforme is the most common and most malignant primary brain tumor, with a yearly incidence of 2.5 in 100,000. It has a very dismal prognosis, since the medium overall survival of untreated patients is as low as 3 months. Location in the central nervous system, high aggressiveness, spreading alongside blood vessels and white matter, cause a lot of therapeutic challenges. The blood-brain barrier unables most of the systemic drugs to reach the tumor and complete resection is usually impossible. Because of that, effects of the standard treatment remain unsatisfying. It forces to search for novel treatment options. Regarding pharmacotherapy a lot of attention is brought to antiangiogenic therapies, where the most common drug is bevacizumab. In Europe it is registered to use in diffuse breast cancer, non-small cell lung cancer, colon and rectal cancer with metastases, but for glioblastoma it's use is still considered to be experimental. Inhibition of integrins, extracellular matrix metalloproteinases and EGFR are among other therapeutic goals. There is a broad range of studies on breaking the resistance of cancer stem cells, modifying the niche of cancer cells, active immunotherapy and the use of microRNAs. The field of stereotactic radiosurgery is also under constant improvement. Methods of both genetic and biomedical engineering, such as nanotubes or liposomes, can be helpful to overcome the blood-brain barrier and insert the drugs directly and even selectively into the tumor.