GLIOBLASTOMA: CURRENT TREATMENT STRATEGIES AND CLINICAL CHALLENGES

Abstract

Glioblastoma (GBM) is the most aggressive primary malignant brain tumor in adults, characterized by complex biology and poor prognosis. The 2021 WHO classification refined the diagnosis, defining GBM by the absence of IDH mutations (IDH-wildtype). This narrative review analyzes current therapeutic strategies and persistent clinical challenges. The gold standard remains the Stupp Protocol (maximum safe resection followed by chemoradiotherapy with temozolomide), with MGMT promoter methylation being the main predictive biomarker. Innovations such as Tumor Treating Fields (TTFields) and NanoTherm therapy emerge as promising adjuvants. However, intratumoral heterogeneity, the blood-brain barrier, and the immunosuppressive microenvironment remain critical barriers to the efficacy of targeted therapies and immunotherapy, keeping recurrence an almost inevitable challenge.