Advanced Neuroimaging and Emerging Systemic Therapies in Glioblastoma: Current Evidence and Future Directions

Area of Science:

• Neuro-oncology
• Medical imaging
• Cancer therapeutics

Background:

• Glioblastoma (GBM) remains a challenging brain tumor with poor prognosis despite technological advancements.
• Neuroimaging plays a crucial role in the diagnosis and monitoring of brain tumors, including GBM.

Purpose of the Study:

• To review current neuroimaging techniques and systemic therapies for GBM.
• To highlight emerging and innovative treatment strategies for glioblastoma.

Main Methods:

• Review of multiparametric MRI (diffusion, perfusion, spectroscopy), PET tracers, radiomics, and AI.
• Analysis of standard treatments (surgery, chemoradiotherapy with temozolomide) and novel therapies (bevacizumab, immune checkpoint inhibitors, CAR-T cells, targeted therapies).

Main Results:

• Advanced imaging (MRI, PET) with AI refines tumor delineation and response prediction.
• Standard therapy (temozolomide) is most effective in MGMT-methylated GBM; other targeted therapies show limited overall survival benefits.
• Emerging therapies like CAR-T and targeted agents show preliminary activity but lack proven durability or broad efficacy in unselected GBM.

Conclusions:

• Integration of advanced imaging, AI, and molecular data is crucial for improving GBM prognostication and treatment selection.
• Future research should focus on blood-brain barrier penetration strategies and harmonized diagnostic-therapeutic approaches.
• Convergence of these fields holds promise for enhancing patient outcomes in glioblastoma.