Introduction
glioblastoma, GBM, cancer, tumor
GLIOBLASTOMA, TUMOR GROWTH, CANCER, TUMOR
The standard of care (SOC) for glioblastoma (GBM) is a combination of surgery, radiotherapy, and concomitant temozolomide followed by maintenance temozolomide (TMZ) as demonstrated by the EORTC-NCIC trial.Due to the unpredictable nature of cancer, responses to chemotherapy can vary from patient to patient, even when cancer cells are of the same histology. Several genome-based methodologies and immunotherapies are under clinical investigation. They have not demonstrated a survival advantage in GBM,A strategy to increase the survival of patients with GBM is to target the cancer stem cells (CSCs) that contribute to therapy resistance and cancer progressionThe “CSC concept” was proposed four decades ago and revised recently and posits that tumor growth is analogous to the renewal of healthy tissues and fueled by small numbers of dedicated stem cells capable of plasticity.For patients with rGBM, a viable treatment option is to select chemotherapies that will eliminate the CSCs, the main cause of treatment resistance, while reducing the bulk of tumor cells.Based on this proof of concept and on real-world data, a multi-institutional, randomized clinical trial (ClinicalTrials.gov: 