(GBM; GBM IDHwt; Glioblastoma IDH wildtype)
Glioblastoma IDH wild type (GBM IDHwt) is the most common infiltrating glioma. Glioma is a type of brain cancer whose cells soak into normal brain tissue.
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Cancer is when cells in the body split without control or order. They go on to form a growth or tumor. The term cancer refers to harmful growths. These growths harm nearby tissues. It is not clear what causes this.
The chances of GBM are higher for people who:
- Are aged 50 years or more
- Are White, Hispanic, or Asian
- Have rare inherited diseases such as Li-Fraumeni syndrome or neurofibromatosis type 1
- Were exposed to radiation to the head
- Were possibly exposed to some types of harmful chemicals
Symptoms depend on the tumor's size and where it is. They may include:
- Symptoms caused by growing pressure to the brain:
- Nausea or vomiting
- Double vision
- Symptoms caused by where the tumor is:
- Problems speaking
- Problems thinking
- Vision problems
- Problems walking
The doctor will ask about symptoms and health history. A doctor may also want to do:
- Imaging tests such as:
- EEG—to test the electrical activity of the brain.
- Biopsy or resection—some of the tumor is removed and tested. This can help doctors learn more about it and make a treatment plan.
- Lumbar puncture—to test the fluid that surrounds the brain and spinal cord. This is not done as often for GBM IDHwt.
Surgery is often done to confirm a diagnosis and to remove as much of the tumor as possible. All of the tumor cannot be taken out with surgery. Other ways to manage GBM IDHwt are:
- Radiation therapy—to shrink the tumor
- Chemotherapy—to improve length and quality of life
- Tumor treating fields
GBM is very hard to treat. It may come back after being removed. It often causes death. A person who has GBM IDHwt may be advised to find:
- Support groups
- Someone to help with end of life planning
- Hospice care
GBM IDHwt cannot be prevented.
- Adult central nervous system tumors treatment (PDQ®)-health professional version. National Cancer Institute website. Available at: https://www.cancer.gov/types/brain/hp/adult-brain-treatment-pdq.
- Brain tumors. American Association of Neurological Surgeons website. Available at: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Brain-Tumors.
- Glioblastoma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/glioblastoma.
- Horbinski, C., Ligon, K.L., et al. The medical necessity of advanced molecular testing in the diagnosis and treatment of brain tumor patients. Neuro-Oncology, 2019; 21 (12): 1498-1508.
- Lukas, R.V., Wainwright, D.A., et al. Newly diagnosed glioblastoma: a review on clinical management. Oncology (Williston Park), 2019; 33 (3): 91-100.
- Lukas, R.V. and Mrugala, M.M. Pivotal therapeutic trials for infiltrating gliomas and how they affect clinical practice. Neuro Oncology Practice, 2017; 4 (4): 209-219.
- Stupp, R., Mason, W.P., et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med, 2005; 352 (10): 987-996.
- Stupp, R., Taillibert, S., et al. Effect of tumor-treating fields plus maintenance temozolomide vs maintenance temozlomide alone on survival in patients with glioblastoma: a randomized clinical trial. JAMA, 2017; 18 (23): 2306-2316.
- Rimas Lukas, MD
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