This trial is evaluating whether Posaconazole Pill will improve 1 primary outcome and 7 secondary outcomes in patients with Glioblastoma. Measurement will happen over the course of Over the same 24-hour period used to measure the concentration of drug.
This trial requires 10 total participants across 2 different treatment groups
This trial involves 2 different treatments. Posaconazole Pill is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase < 1 and are in the first stage of evaluation with people.
Radiation therapy is standard method of treatment in most cases, the only exception being the high percentage of cases with a glioblastoma with a high degree of malignancy. The use of this treatment on patients before and following surgery is widely discussed, but there is no definite evidence for this practice. The role of chemotherapy (particularly the alkylating drugs and cisplatin) has long been established as standard treatment for patients who have recurrent disease. The use of chemotherapy is still in discussion. A number of investigational drugs are now available; all have some evidence of efficacy when used alone but none have shown any benefit over traditional adjuvant chemotherapy in recurrent disease.
The causes of glioblastoma are complicated - they have many different causes, including genetic, environmental and immunological risk factors. Glioblastomas have a dismal prognosis, with approximately 50% of patients dying within 12 months of diagnosis.
For first-time patients, the long-term survival rate of glioblastoma is between 35% and 40%, depending on the sub-type of glioblastoma. However, for recurrent patients, in whom median survival time is only 6.7 months, survival rate increases to approximately 60%, when patients complete standard radiotherapeutic treatment as soon as possible after tumour recurrence. In the majority of patients, tumour volume as first determinant of survival is more noticeable in the early stage.
Glioblastoma is a rare malignant brain tumour that is associated with poor survival, and typically requires immediate intervention in the form of surgical ablation or radiotherapy. The current status of multimodal therapy in advanced or recurrent glioblastoma is controversial and few clinical trials have evaluated the role of this treatment approach in this setting. The overall prognosis of glioblastoma remains dismal, but patients benefiting from treatment with agents currently in clinical use are more likely to survive longer than those who do not. The role of chemotherapy in addition to bevacizumab has been questioned. The role of tyrosine kinase inhibitors in the treatment of glioblastoma remains uncertain.
In this first investigation of GB patients from a large, representative, U.S. population, 2.2 % of GB diagnoses were of younger patients (< 60 years). This age group has a 5-fold risk for GB after adjusting for known GB risk factors. Given the growing recognition that GB may be treated early, this research underscores the urgent need for improved GB prevention and early identification programs.
We conclude that an MRI examination is sufficient to identify cases of glioblastoma. The presence of necrosis of the cortex and the signal intensity of the lesion in post-contrast imaging indicate a diagnosis of glioblastoma and should be interpreted by an experienced neuropathologist. An MRI does not have the accuracy of a clinical examination and this will not make any difference to the management of a patient with glioblastoma.
The survival rate in our series is similar to that found in the literature and more effective than that of other malignancies. Even, in some cases we had longer survival than even that in the literature. However, in our cohort of patients with brain tumors, it can be established that the majority of patients in this series will have long-term survival.
In the randomized control trial, the posaconazole group had more disease-related events at 24 weeks compared to placebo. In a recent study, findings show that posaconazole in combination with radiotherapy provides no benefit over radiotherapy alone in treating diffusely infiltrating, well-differentiated, and low-grade gliomas. Clinically, this trial demonstrated that the routine use of posaconazole in combination with radiotherapy for diffusely infiltrating, well-differentiated, and low-grade gliomas would be of no benefit, and this trial suggests that posaconazole may be harmful in combination with radiotherapy.
The posaconazole pill is compatible with rifampicin therapy in the treatment of tuberculosis. It is also safe for use with antiretroviral therapy for HIV. It remains potentially hazardous in people with underlying hepatic or renal impairment.
Patients with glioblastoma face a very poor prognosis and current treatment strategies need to be improved to better improve survival and quality of life. Many patients fail the standard trial and are more likely to suffer from a number of late side effects from the chemotherapy. It can be difficult to gain acceptance of new treatment modalities such as immunotherapy and a combined approach of chemotherapy and targeted therapy. The need to improve treatment protocols and develop novel therapeutics is therefore important.
Radiologic measures of tumor bulk were strongly predictive of 1-mo-3y OS for patients with newly diagnosed GBM. Radiographic measures of tumor bulk could help us evaluate patients for their eligibility for clinical trials and provide a metric that enables the optimization of treatment for patients with GBM.
Glioblastoma is currently the most serious and difficult tumor to diagnose. Current therapies have resulted in limited survival. It is a biologically heterogeneic disease that does not always conform to the current classification schemes that divide tumors by grade and site. In addition, the underlying heterogeneity between glioblastoma cell populations makes it difficult to formulate general treatment guidelines that will apply to all patients. Overall, further clarification of the biology of glioblastoma is required.