Table 2 Example questions and their answers generated by models

What is a reirradiation dose/fractions for recurrent glioblastoma?

The most common approach involves the use of fractionated stereotactic radiotherapy with or without intensity modulation and a median total dose of 30–36 gy. Stereotactic radiosurgery (the administration of one single fraction), is rarely used in glioblastoma because of the poorly defined target volume. None of the reirradiation schedules has ever been looked at in a prospective or controlled fashion. The recent apg101 trial provided no sign of efficacy for reir Radiation at × 2 gy in recurrent glioma patients. temsirolimus administered weekly at the dose of mg / m 2 also did not show efficacy in children with high-grade gliomas.

What is median overall survival in patients with recurrent glioblastoma?

Bevacizumab alone had a median overall survival of about 7–10 months from recurrence, and this efficacy was comparable to lomustine monotherapy. For patients with recurrent glioblastoma, chemotherapy regimens are associated with overall response rates of 4–9%, 6-month progression-free survival (pfs) of 10–19%. Even with these treatments, median overall survival after recurrence is 6. 2 months. fda-approved treatment options remain few and the prognosis remains dismal with a median survival of 14. 6 months and a 5-year-survival rate of 9.

Are immune checkpoint inhibtors are available for patients with recurrent glioblastoma?

There are many ongoing clinical trials with immune checkpoint inhibitors in patients with primary and recurrent glioma / glioblastoma. challenges in the design and conduct of clinical trials for immunotherapies are numerous, particularly in trials involving patients with gliOBlastomas. different measures of response are required for checkpoint inhibitors, and the management of immune-related adverse events in the cns are a concern. as immunotherapy becomes more widely available, the potential increases for both synergies and adverse interactions between conventional gliobeastsoma therapies and immune checkpoint inhibitor. There are currently limited data on immune checkpoints in other types of gliomas such as oligodendroglioma.

What molecular targets are potentially promising for recurrent glioblastoma?

Molecular therapies that targeted rtks are promising therapeutic strategies for glioblastoma tumors. Clinical trials have not shown promising combinational therapies of temsirolimus with bevacizumab (vegf inhibitor), sorafenib (raf inhibitor), erlotinib (egfr inhibitor), or radiation therapy. The molecular target expression status, as determined at the time of primary resection, may not necessarily present rational treatment clues for the care of recurrent gbm that occurs 6–9 months later. The lpa 1 antagonist ki16425 (kirin brewery co., takasaki, japan) effectively suppresses the lpa-induced motility of gliobeasts.

Is MGMT status associated with the incidence of recurrent glioblastoma?

Methylated mgmt status determined by msp was correlated with better outcome. The prognostic value of the mgMT status in patients with recurrent glioblastoma is not well defined. Future research will shed light on which patients should undergo a second resection or radiotherapy procedure. It will also shed light how to best use tmz and bevacizumab therapy, and the value of mgmt Status assessment in the recurrent setting. The study also found that mgmtstatus did not appear to change between primary and recurrent tumors. It is positively associated with gliOBlastoma sensitivity to alkylating agents, such as temozolomide.

What is the pattern of care in recurrent glioblastoma?

Radiotherapy remains an important part of the standard-of-care treatment for patients with malignant gliomas. Despite definitive data, standard of care guidance for managing patients with recurrent or progressive glioblastoma is evolving. The diffusely infiltrative pattern of progression might be associated with a slower cause of the disease, as it has been suggested by radiological patterns of recurrence of patients treated with bevacizumab. The 6-month pfs rate (pfs6) is the optimal end point for treatment of recurrent gliOBlastoma. Participation in clinical trials is encouraged for the treatment of this type of cancer. The primary purpose of this paper is to discuss the role of second-line monotherapy and combination therapies.