Neuro-Oncology Learning Portfolio: An Update on Glioblastoma
James J. Vredenburgh, MD
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James Vredenburgh, MD: Hello and welcome to the Duke University School of Medicine Neuro-Oncology Portfolio on MedscapeCME Oncology, “An Update on Glioblastoma.” This educational initiative is a collaborative partnership of Duke University School of Medicine, the National Comprehensive Cancer Network, and MedscapeCME Oncology. The goal of this collection of CME activities about primary brain tumors is to expand clinicians’ understanding of this cancer and the unique challenges associated with it, as well as to provide the latest information on current and emerging treatment strategies.
My name is Dr. James Vredenburgh. I am Medical Director of the Adult Clinical Services at the Preston Robert Tisch Brain Tumor Center and Professor of Medicine at Duke University Medical Center in Durham, North Carolina. I am pleased to serve as the Medical Director for this collection of educational activities on MedscapeCME Oncology.
Although the incidence of brain tumors in general, and glioblastoma multiforme in particular, is lower than that of solid tumors elsewhere in the body, the challenges involved in treatment are highly complex. Surgical excision is more dangerous because of the location of these tumors in the brain, and many of the tumors are inoperable. In addition, drug therapy is significantly impeded by the protective mechanisms that comprise the blood-brain barrier.
Glioblastoma multiforme is the most aggressive of the infiltrating gliomas and is the most common CNS [central nervous system] malignancy, accounting for 19% of all primary brain tumors. The incidence of glioblastoma multiforme increases with age and the relative survival estimates for glioblastoma multiforme are quite low, with fewer than 10% of patients alive 5 years after diagnosis.
Surgery plays an important role as the initial clinical step in the management of glioblastoma multiforme. Clinical studies have demonstrated that radiation therapy following surgical resection improves patient outcomes and this approach was the standard of care for many years. The role of chemotherapy in the management of glioblastoma has become increasingly important. Alkylating agents, such as temozolomide, combined with radiation therapy and surgery have become part of the standard of care for patients with newly diagnosed glioblastoma. Unfortunately, most patients treated in the first-line setting will have disease recurrence, and it has been suggested that glioblastoma recurrence is inevitable.
Systemic therapies are often used in patients with recurrent disease. Recently, some classes of targeted therapies have demonstrated efficacy in glioblastoma, with implications for promising new strategies in the future. Because of the complexity of treating patients with brain tumors, a multidisciplinary approach delivered by a neuro-focused team of professionals is critical. Patients with glioblastoma multiforme and other CNS tumors experience numerous disease-related symptoms, and treatment-related complications can have a significant impact on their quality of life.
The Preston Robert Tisch Brain Tumor Center at Duke University was established in 1937 as one of the first brain tumor research and clinical programs in the United States. Since then, the Center has advanced to become one of the leading pediatric and adult neuro-oncology programs in the world, leading the way in comprehensive care with a unique combination of research breakthroughs, clinical trials, and the newest therapies. At the core of the Center’s success lies the commitment of countless physicians, midlevel providers, nurses, researchers, and all the staff with their collective goal of caring for patients and their families, improving the quality of everyday life and, ultimately, finding a cure.
MedscapeCME Oncology, recognized as the premier developer of health and medical education, provides unmatched online reach to all the professionals on the neuro-oncology team. In addition, Duke University and MedscapeCME Oncology are pleased to partner with the National Comprehensive Cancer Network, which examines and reviews the content of these educational activities to enhance accuracy and fair balance. We hope you will find this portfolio of educational activities interesting and useful to your efforts to improve patient care and outcomes and support patients and families. Please bookmark this page and visit often.
This activity is supported by an independent educational grant from Bristol-Myers Squibb, EMD Serono, Genentech BioOncology, Millennium Pharmaceuticals, Inc., and Merck.
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