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Updated: Sep 22, 2025
Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma
Published on: October 27, 2014
[Glioblastoma That Does Not Improve with Standard Treatment: Poor Prognostic Factors and Future Perspectives]
1Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital.
Abstract:
The 5-year survival of glioblastoma (GBM) is at approximately 15%, and prognostic factors of GBM are age, Karnofsky performance status (KPS), extent of resection, and MGMT promoter methylation status. The reasons for the poor prognosis of GBM are as follows: 1)median age of onset of GBM is 68 years; 2)half of the patients have KPS≤70; 3)rapid growth of the tumor; 4)half of the patients undergo total resection; and 5)available drugs are only temozolomide and bevacizumab. The comprehensive genome profiling test is performed to analyze exome gene mutations, amplifications, deletions, and fusion gene expression in tumor tissues with a next-generation sequencer to identify tumor-specific driver genes. This test has been covered by public medical insurance for patients with cancer, including malignant brain tumors, in Japan since 2019. It detects the driver genes of GBM, such as BRAF and FGFR gene mutations, leading to clinical application by those inhibitors.
Insights
Glioblastoma (GBM) has a poor 5-year survival rate. Comprehensive genome profiling identifies specific driver genes, enabling targeted therapies for this aggressive brain cancer.
Area of Science:
- Neuro-oncology
- Genomics
- Cancer Research
Background:
- Glioblastoma (GBM) exhibits a dismal 5-year survival rate of approximately 15%.
- Key prognostic factors for GBM include patient age, Karnofsky performance status (KPS), extent of tumor resection, and MGMT promoter methylation status.
- Poor prognosis is attributed to advanced age at onset, low KPS scores, rapid tumor growth, incomplete resection, and limited therapeutic options.
Purpose of the Study:
- To investigate the utility of comprehensive genome profiling for identifying tumor-specific driver genes in glioblastoma.
- To explore the clinical application of next-generation sequencing (NGS) for detecting actionable mutations in GBM.
- To highlight the impact of insurance coverage for comprehensive genomic profiling in Japan since 2019.
Main Methods:
- Comprehensive genome profiling using next-generation sequencing (NGS) was performed on tumor tissues.
- Analysis included exome gene mutations, amplifications, deletions, and fusion gene expression.
- Identified specific driver genes such as BRAF and FGFR mutations.
Main Results:
- NGS successfully identified tumor-specific driver genes in glioblastoma.
- Detection of actionable mutations like BRAF and FGFR provides therapeutic targets.
- Comprehensive genomic profiling is now covered by Japanese public medical insurance for malignant brain tumors.
Conclusions:
- Comprehensive genome profiling is a valuable tool for identifying GBM driver genes.
- Targeted therapies based on identified mutations, such as BRAF and FGFR inhibitors, offer potential treatment strategies.
- Increased accessibility through insurance coverage facilitates the clinical application of genomic profiling for GBM patients.
