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Pivotal therapeutic trials for infiltrating gliomas and how they affect clinical practice

Rimas V Lukas1, Maciej M Mrugala1

  • 1University of Chicago, Department of Neurology (R.V.L.); University of Washington, Department of Neurology (M.M.M.).

Neuro-Oncology Practice
|August 7, 2019
PubMed

Insights

This review examines FDA-approved and NCCN-recommended treatments for low- and high-grade gliomas. It details systemic therapies like temozolomide and local treatments such as tumor-treating fields for primary brain tumors.

Area of Science:

  • Neuro-oncology
  • Oncology
  • Clinical Neurology

Background:

  • Management of low- and high-grade infiltrating gliomas presents daily challenges in neuro-oncology.
  • Anaplastic and low-grade primary brain tumors require careful treatment considerations.

Purpose of the Study:

  • To review current therapeutic strategies for infiltrating gliomas.
  • To focus on treatments approved by the FDA and/or included in NCCN Guidelines.

Main Methods:

  • Evaluation of systemic therapy trials including temozolomide, bevacizumab, and procarbazine, lomustine, vincristine (PCV).
  • Assessment of local therapy trials, including surgical interventions with carmustine wafers and tumor-treating fields.
  • Discussion of pivotal trials and correlative studies in primary brain tumor treatment.

Main Results:

  • Systemic agents like temozolomide and PCV show efficacy in glioma treatment.
  • Local therapies, including carmustine wafers and tumor-treating fields, offer alternative management options.
  • Pivotal trials provide evidence for various treatment modalities in gliomas.

Conclusions:

  • The therapeutic landscape for gliomas is dynamic, with evolving treatment options.
  • FDA-approved and NCCN-guided therapies form the basis of current clinical decision-making.
  • Continued research and evaluation of pivotal trials are crucial for advancing glioma management.
Keywords:
bevacizumabgliomalomustinetemozolomidetumor treating fields

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