What impact does therapy selection have on the course of clinical outcomes for recurrent gliomas?

Aim: The most prevalent primary malignant brain tumor in humans is called glioblastoma (GBM). The prognosis is still dismal despite vigorous multimodal treatment, and many patients pass away from local recurrence. Recurrence happens in almost all cancers, even with state-of-the-art techniques and ideal multidisciplinary therapies comprising conformal radiotherapy, maximal surgical resection, and systemic medications. The development of effective medications for the treatment of recurrent glioblastoma is severely hampered by molecular heterogeneity and treatment-associated inherited or acquired resistance. Materials and methods: Twenty patients with recurrent gliomas were included in the study out of the 133 patients who had a glioma diagnosis between 2015 and 2021. Information was gathered from the patient's records and documentation. Results: Relapses occurred on average after 30.1 (range: 5.7-182.6) months. The average patient age upon diagnosis was 51 (range: 24-68). Males made up 65% of the patients. Systemic treatment was given to 17 individuals (85%). 70.5% of patients preferred the bevacizumab+irinotecan (BEV+IRI) regimen as their first-line treatment. Carmustine (5.5%) and temozolomide rechallenge (23.5%) were the other regimens. Patients who underwent systemic treatment following a relapse had an average overall survival of 8.1 months. 53.8% was the 6-month OS for patients following recurrence. Discussion: Consequently, these patients have low systemic treatment effectiveness. Treatment results that are curative are uncommon. The influence of the proposed treatment on performance status and quality of life ought to be taken into account, regardless of the severity of the disease. A less risky regimen or active surveillance may be beneficial for patients with gliomas that do not show targetable pathological alterations, as there was no statistically significant difference seen when progression-free survival lengths were evaluated. It is necessary to develop customized treatments. Targeted therapy development requires large scale investigations looking into genetic alterations.