A review of standard therapeutic approaches and clinical trials for treating gliomas with an eye towards the immunotherapy future

Abstract

The standard treatment for glioma is surgery, followed by extended local irradiation and chemotherapy. In patients with newly diagnosed glioblastoma(GBM), however, combined radiotherapy (RT. and temozolomide (TMZ) treatment followed by adjuvant TMZ for at least 6 months offers a modest benefit, with a median survival of 14.6 months. Currently, therapeutic options with evidence confirming their efficacy in glioma patients are limited, although some new approaches, such as carmustine wafers and bevacizumab, are available for clinical use in many countries. Thus, surgical maximal resection followed by combined RT and TMZ is still recognized as the standard therapy for newly diagnosed GBM. In this review, focusing on surgery with photodynamic diagnosis with 5‒aminolevulinic acid, carmustine wafers, bevacizumab and talaporfin sodium, the world and domestic standard approaches against gliomas were extensively reviewed with an implication for the new WHO classification emerging in this year. In addition, cancer immunotherapy against gliomas, which is expected as the next generation of standard care, is introduced and thoroughly reviewed.