Glioblastoma multiforme: An updated review of pathophysiology, diagnosis,and temozolomide-based therapy

Abstract

Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults, characterized by its rapid progression and poor prognosis. Malignant gliomas (Glioblastoma Multiforme) found in brain and occur more frequently than other types of primary tumors. Temozolomide, a second- generation alkylating agent is a new drug work against the glioblastoma multiforme. Alkylating agents are some traditional drugs act by producing mis- match of DNA and inhibit the replication of DNA Temozolomide, an oral alkylating agent, has emerged as a standard chemotherapy option for GBM treatment. This review aims to summarize the efficacy and safety of temozolomide in the management of GBM. Clinical trials and retrospective studies have demonstrated that the addition of temozolomide to standard radiotherapy significantly prolongs both progression-free survival (PFS) and overall survival (OS) in patients with newly diagnosed GBM. Furthermore, temozolomide is often used as maintenance therapy following chemoradiation, contributing to prolonged survival outcomes. However, temozolomide treatment is associated with several adverse effects, including nausea, vomiting, myelosuppression, and fatigue. Management of these side effects is essential to optimize patient outcomes and adherence to treatment. The efficacy of temozolomide may be influenced by various factors, including the methylation status of the O^6-methylguanine-DNA methyltransferase (MGMT) gene promoter and the presence of other molecular biomarkers. Ongoing research is focused on identifying predictive biomarkers and developing novel treatment strategies to improve outcomes for patients with GBM. In conclusion, temozolomide plays a critical role in the