Updates to contemporary care of glioblastoma

Glioblastoma is the most common and aggressive primary malignant brain tumor in adults. Over the years, the diagnostic criteria have been refined, incorporating molecular markers with histology to reflect the underlying tumor biology. Advances in genomics and molecular techniques are currently focused on trying to subcategorize the tumors for potential prognostic and clinical purposes. Treatment consists of multiple modalities including surgery, radiation, and systemic treatments. While targeted therapy traditionally has not been effective due to the heterogeneity of the tumor, fusions and certain mutations may benefit from specific targeted therapies. Tumor treating fields is a novel treatment that has shown survival benefit in newly diagnosed glioblastoma, and ongoing trials are underway to capitalize on its mechanism. Finally, special consideration should be given to palliative care in light of the high morbidity and mortality associated with glioblastoma. In particular, the balance of aggressive care and quality of life must be weighed in the geriatric population though contemporary studies have shown good tolerance for a hypofractionated course of chemoradiation.