Advances in the Treatment of Malignant Gliomas: A Review of the Literature

Abstract

Goal: The objective of this review is to describe the latest therapeutic advances used for managing patients diagnosed with recurrent malignant gliomas.
Methods: A comprehensive bibliographic review was conducted in the PubMed, Scopus, EBSCO, and Elsevier databases; articles published between 2018 and 2023 were selected and analyzed.
Results: The management protocol for patients with glioblastomas depends on the imaging diagnosis of the lesion and time of diagnosis; thus, significant differences can be found in the therapeutic strategies between the de novo diagnoses and recurrences. Thus, de novo glioblastomas have standardized protocols substantiated by maximum safe resection, followed by cycles of chemotherapy and radiation therapy. Adjuvant therapies are used for recurrent glioblastomas, and among them, molecular therapies and immunotherapy stand out. However, despite the advent of genetic modification and neurosurgery technologies, there has been no significant impact on the medium- and long-term survival of patients with glioblastomas.
Conclusions: Therapeutic measures are based on neurosurgery to achieve maximal safe surgical resections associated with postoperative chemotherapy and radiotherapy sessions with lower secondary complications. In patients with recurrent neoplasms, the use of adjuvant therapies such as bevacizumab and immunotherapies is indicated, though limited therapeutic results and minimal impacts have been found for the overall survival rates. Hence, extensive clinical follow-up is required to improve the understanding of the disease and effectiveness of these novel therapeutic alternatives.