Systemic Treatment in Glioblastoma

Glioblastoma is the most common primary brain tumor and the initial treatment with maximal safe resection is not curative. In order to improve the prognosis, surgery is completed with radiotherapy and temozolomide, an oral chemotherapy, but overall survival remains poor. Therefore, new efforts are needed to improve these results. In fact, different systemic treatments have been tested but, nevertheless, few advances have been reached despite the development of large clinical trials. This chapter will review the most important findings, achievements, and main studies in this pathology. Standard of care in newly diagnosed and recurrent glioblastoma will be reassessed with the results of clinical trials with targeted agents and immunotherapy. Ongoing studies are evaluating advanced treatments, with chimeric antigen receptor T-cells, biospecific T-cell antibodies, tumor vaccines, and oncolytic viruses, although results are pending, a wide review of these new-generation agents is important to better understand the advances in glioblastoma in the coming years.