
Contents
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Definition Definition
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Epidemiology Epidemiology
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Histology and molecular pathogenesis Histology and molecular pathogenesis
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Clinical presentation Clinical presentation
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Imaging Imaging
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Management Management
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Adults Adults
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Surgery Surgery
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Radiotherapy Radiotherapy
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Systemic pharmacotherapy Systemic pharmacotherapy
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Quality of life, neurocognitive function, survivorship, palliative care Quality of life, neurocognitive function, survivorship, palliative care
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Surveillance recommendations Surveillance recommendations
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Identification and commentary on NCCN, EANO, and any other treatment guidelines Identification and commentary on NCCN, EANO, and any other treatment guidelines
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Pediatric malignant glioma Pediatric malignant glioma
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General approach to treatment General approach to treatment
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Surgery Surgery
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Radiotherapy Radiotherapy
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Systemic pharmacotherapy Systemic pharmacotherapy
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Quality of life, neurocognitive function, survivorship, palliative care Quality of life, neurocognitive function, survivorship, palliative care
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Surveillance recommendations Surveillance recommendations
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Identification and commentary on NCCN, EANO, and any other treatment guidelines Identification and commentary on NCCN, EANO, and any other treatment guidelines
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References References
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2.1.3 Glioblastoma, IDH-wildtype
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Published:April 2025
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Abstract
The 2021 World Health Organization (WHO) classification defines glioblastoma as a malignant tumor of neuroglial or astroglial origin that lacks mutations in the isocitrate dehydrogenase (IDH) 1 or 2 genes. The new definition of glioblastoma also includes IDH-wildtype tumors without histological features of WHO grade 4 if one of the following three molecular signature lesions is detected: epidermal growth factor receptor (EGFR) amplification, combined chromosome 7 gain and chromosome 10 loss (+7/−10 signature), and telomerase reverse transcriptase (TERT) promoter mutation. The standard of care for most patients with glioblastoma is resection as safely feasible followed by radiotherapy with concomitant and maintenance temozolomide. Treatment standards at recurrence are less well defined. Lomustine is probably the most widely used systemic pharmacotherapy at recurrence. Bevacizumab is approved for recurrent disease in some countries whereas immunotherapy has not been shown to be active in glioblastoma yet. Novel therapeutic approaches are urgently needed.
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