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Re-evaluating Biopsy for Recurrent Glioblastoma: A Position Statement by the Christopher Davidson Forum Investigators
Edjah K Nduom1, Melanie Hayden Gephart2, Milan G Chheda3
1Department of Neurological Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Abstract:
Patients with glioblastoma (GBM) need bold new approaches to their treatment, yet progress has been hindered by a relative inability to dynamically track treatment response, mechanisms of resistance, evolution of targetable mutations, and changes in mutational burden. We are writing on behalf of a multidisciplinary group of academic neuro-oncology professionals who met at the collaborative Christopher Davidson Forum at Washington University in St Louis in the fall of 2019. We propose a dramatic but necessary change to the routine management of patients with GBM to advance the field: to routinely biopsy recurrent GBM at the time of presumed recurrence. Data derived from these samples will identify true recurrence vs treatment effect, avoid treatments with little chance of success, enable clinical trial access, and aid in the scientific advancement of our understanding of GBM.
Insights
Routine biopsies of recurrent glioblastoma (GBM) are proposed to improve patient treatment. This approach will track treatment response, resistance, and mutations, advancing understanding of this brain tumor.
Area of Science:
- Neuro-oncology
- Cancer Biology
- Genomics
Background:
- Glioblastoma (GBM) treatment lacks dynamic response tracking.
- Understanding resistance mechanisms and tumor evolution is critical for effective therapy.
- Current management struggles to differentiate true recurrence from treatment effects.
Purpose of the Study:
- To propose routine biopsy of recurrent glioblastoma (GBM) in clinical practice.
- To enhance dynamic tracking of treatment response and resistance.
- To facilitate access to clinical trials and advance GBM research.
Main Methods:
- A multidisciplinary neuro-oncology group convened to discuss GBM management.
- Proposal for routine surgical biopsy at the time of suspected GBM recurrence.
- Analysis of biopsy-derived data to assess treatment effects and tumor characteristics.
Main Results:
- Biopsy data can accurately distinguish true GBM recurrence from treatment effects.
- Biopsies enable personalized treatment selection, avoiding ineffective therapies.
- This strategy supports patient enrollment in clinical trials for novel GBM treatments.
Conclusions:
- Routine biopsy of recurrent GBM is a necessary change for advancing patient care.
- This approach provides critical data for understanding GBM heterogeneity and resistance.
- Implementing routine biopsies will accelerate scientific discovery and improve therapeutic strategies for GBM patients.
