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Epidemiologic and molecular prognostic review of glioblastoma

Thakkar JP, Dolecek TA, Horbinski C, Ostrom QT, Lightner DD, Barnholtz-Sloan JS, Villano JL (2014) Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiol Biomarkers Prev 23(10):1985-1996. doi: 10.1158/1055-9965.EPI-14-0275 PMID: 25053711

Objective: The authors report on the current epidemiology of glioblastomas (GBM) with data from the Central Brain Tumor Registry of the United Stated (CBTRUS) as well as discuss the trends in incidence and survival. They provide a review on molecular markers in GBM that helped distinguish the similar subtypes of GBM and have prognostic and predictive value.

Summary: GBM is the most common brain and CNS malignancy, accounting for 45.2% of malignant primary brain and CNS tumors, 54% of all gliomas, and 16% of all primary brain and CNS tumors. GBMs comprise of primary and secondary subtypes which evolve through different genetic pathways, affect patients at different ages and have differences in outcomes. While many studies have investigated the basis of incidence differences by gender, age, race, and risk factors for GBM, many of these studies had inconclusive findings. The field has invested significant resources on the characterization for the various subclassifications of GBM and is in position to advance therapies specific to the genetic abnormalities of each. The success of m-TOR pathway inhibition for subependymal giant-cell astrocytomas and the possibility of identifying a subtype of GBM sensitive to up-front treatment with bevacizumab are examples. The complex molecular changes associated with GBM will likely make personalized therapy challenging. Although clinical advances in GBM are rare, the authors look to the new era in cancer biology we are in for meaningful advances.

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