Status quo--standard-of-care medical and radiation therapy for glioblastoma.

There will be approximately 10,000 new cases of glioblastoma diagnosed in the United States this year alone. Although a relatively rare cancer, these aggressive tumors lead to a disproportionate amount of cancer morbidity and mortality. The current standard treatment for a glioblastoma consists of surgery for cytoreduction and/or biopsy followed by chemoradiation and adjuvant temozolomide. Without treatment, most patients will die of their disease within 3 months of diagnosis. Surgical intervention can extend survival to 9 to 10 months, and this can be lengthened to 12 months with the addition of adjuvant radiation. In a 2005 landmark clinical trial, Stupp et al demonstrated that temozolomide, an oral DNA-alkylating chemotherapeutic agent, when added to radiation, can improve survival to 14.6 months. Although the effect on survival is modest, this treatment course represents a significant improvement over chemotherapy agents widely used for the 3 previous decades. This review will focus on the development of temozolomide and its use along with radiation therapy as the current standard treatment for glioblastoma.