Ipilimumab for Recurrent Glioblastoma

"Tumor heterogeneity, epigenetic regulation, and the expression of specific oncogenic signaling pathways are implicated in glioblastoma. Furthermore, the loss of the PTEN tumor suppressor gene and amplification of the IDO pathway characterize this tumor type and may represent a potential therapeutic target." - Anonymous Online Contributor

"Data from a recent study suggest that the majority of patients (75%) had at least one symptom in the 1-year period before diagnosis. The most frequent symptoms were headache (49%), seizures (46%), and vomiting (25%). Because glioblastoma has a very short survival, patients should be given a careful assessment of symptoms in the 1st months to 1-year period post-diagnosis and encouraged to report any suspicious symptoms to the doctors." - Anonymous Online Contributor

"In the United States approximately 70,000 patients are diagnosed with glioblastoma and 10-13,400 dying of the disease per year. These deaths are due to the high relapse rate and the long period between diagnosis and relapse, sometimes over 10 months. There is also a great disparity in the survival for patients with different subtypes of glioblastoma, where about 5% of patients survive a year after diagnosis, compared with around 50% who survive for 2 months or more following their initial treatment. There is also a difference between genders where around 33% of females have an overall survival of less than 2 months." - Anonymous Online Contributor

"Glioblastomas are the most common primary brain malignancy in children (aged 3-19), with the majority of cases being WHO grade 4 astrocytomas. Despite the increase in the number of cases, the survival rates are less favorable than the reported survival rate for tumors in other brain regions. This is likely attributable to the heterogeneity in the patient population, and an array of pathogeneses at play that requires further exploration." - Anonymous Online Contributor

"While chemotherapy is the first choice for newly diagnosed cases that fail to respond to surgery, radiation therapy is frequently initiated in the second line when the first-line regimen fails. For relapse or for recurrent disease, chemotherapy with a second-line agent may be given, and radiotherapy may be considered if chemotherapy does not resolve the disease." - Anonymous Online Contributor

"Currently, the only potentially curative therapy for GBM is GBM surgery. However, a percentage of patients will experience tumor recurrence, even in low-grade gliosarcomas, necessitating subsequent chemotherapy to achieve prolonged survival. Even in patients with low-grade tumors, the rate of progression is high. Long-term disease-free survival is achievable only rarely. In a recent multicenter phase III study, only 23% of patients had a long-term progression-free survival, as determined by an extension of the mean survival of the initial population. Because of the low long-term survival rate, we believe that GBM cannot be cured." - Anonymous Online Contributor

"These side effects occurred in most patients and did not cause dosage adjustments. In some patients, side effects were persistent. All patients experienced fatigue, and one patient experienced diarrhea and myelosuppression. Mild nausea and rash occurred occasionally. No other side effects were notable." - Anonymous Online Contributor

"Clinical trials of ipilimumab were published in the peer-reviewed literature in 2008 and 2009. A summary is presented with references for those publications which may be of interest to the patient/physician at hand. The clinical trial studies include 1. Phase II trials for refractory melanoma and renal and hepatocellular carcinoma. These trials include patients with advanced solid organ tumors, including gastrointestinal stromal tumor (GIST) and pancreatic neuroendocrine carcinoma. These patients were treated for advanced cancers with a variety of immunotherapies including ipilimumab. 2." - Anonymous Online Contributor

"Ipilimumab is safe in people with metastatic cancer of any type. There was no evidence of significant neurological side effects. Ipilimumab should be avoided in people with known hypersensitivity to pembrolizumab or any of the active ingredients except for ipilimumab" - Anonymous Online Contributor

"In the case of GBM, when there were several sites of dissemination at presentation and the patient had undergone surgery, chemotherapy, and radiotherapy, the disease tended to remain localised. However, when only sites close to the tumour arose from the dissemination of the tumour, the disease often grew systemically and invaded other sites. An overview of this is illustrated in the image in this section. This may help physicians to decide whether to administer radiotherapy or chemotherapy after surgery to prevent disease spread." - Anonymous Online Contributor

"The majority of patients diagnosed with glioblastoma are younger than is typically reported. These data call into question what the true prevalence of the disease is and whether the current diagnostic criteria are appropriate." - Anonymous Online Contributor

"In a recent study, findings provides evidence that siblings of glioblastoma patients appear to have an increased risk of developing glioblastoma. However, the relative risk is small and not statistically significant when adjusting for environmental factors known to affect the incidence of glioblastoma. The significance of these findings will require further confirmation." - Anonymous Online Contributor