Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Glioblastoma Management
5 items
Treatment Evidence and Guidelines1 item
Essential Evidence for Glioblastoma: A Must-Know for Neurosurgery Exams
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Preparing for neurosurgery exams? Glioblastoma remains one of the most challenging topics, but focusing on the right evidence-based advancements can make all the difference. , I’ll highlight 7 key treatments you need to know for your exams
video11:06 · Jul 2026
Translational Research4 items
Time-dependent cytokine landscapes in an ex vivo microfluidic glioblastoma platform
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Glioblastoma (GBM) is the most common and aggressive astrocytic glioma of the central nervous system with a median survival of 15 months from diagnosis. Patient outcomes have improved only marginally over the past 20 years, and GBM research
article · Jul 2026
Investigating the effects of arginine methylation inhibitors on microdissected brain tumour biopsies maintained in a miniaturised perfusion system
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Arginine methylation is a post-translational modification that consists of the transfer of one or two methyl (CH3) groups to arginine residues in proteins. Several types of arginine methylation occur, namely monomethylation, symmetric dimet
article · Jul 2026
HULL'S MAGIC BOX: BUILDING THE CASE FOR CLINICAL TRIALS USING ARGININE METHYLATION INHIBITORS AGAINST GBM
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AIMS • Assess/evaluate transcriptomic changes in GBM, maintained on a microfluidics system, in response to treatment with arginine methylation inhibitor GSK3368715, currently in …
article · Jul 2026
Our novel glioblastoma microfluidic platform
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4 min Video , revealing our novel glioblastoma microfluidic platform keeping Human GBM tissue alive for up to 12 days, allowing testing thraputic drugs in mimicking brain environment modle. 🧠💡
Delighted to collaborate with other innovati
video4:32 · Jul 2026
Radiosurgery and Radiation Therapy
1 item
Brain Metastases1 item
Efficacy and safety of stereotactic radiosurgery versus whole brain radiotherapy for the treatment of brain metastasis: a systematic review and meta-analysis
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SRS enhances survival and local tumor control but is associated with an increased risk of distant brain recurrences. Due to its safety profile, SRS is recommended for high-risk patients, as it preserves short-term quality of life and mainta
article · Jul 2026
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Maximal safe resection remains the cornerstone of glioblastoma management, with RANO classification stratifying outcomes: supramaximal resection (Class 1, <5 cm³ non-enhancing residual) achieves 24-month median OS, versus 19 months for maximal (<1 cm³ enhancing residual), 15 months for submaximal, and 10 months for biopsy alone. The Stupp protocol—60 Gy radiotherapy with concurrent temozolomide 75 mg daily, followed by six adjuvant cycles at 150–200 mg/m²—defines the standard. Surgical adjuncts improve resection rates: 5-ALA fluorescence guidance (20 mg/kg oral, 2–4 hours preop) increases complete resection from 36% to 65% and extends 6-month PFS, while intraoperative MRI enhances completeness without increasing deficits. Awake craniotomy permits eloquent-area mapping but demands careful selection. Bevacizumab (anti-VEGF) adds only months to OS and lacks European cost-effectiveness approval. Tumor-treating fields with temozolomide extends PFS by 2.7 months and OS by 4.9 months; UK trials are ongoing. Microfluidic ex vivo platforms now sustain patient tissue 8–12 days, revealing cytokine dynamics (EGF/MMP9 suppression, SENES3L1 resistance signals) under novel agents, offering a translational bridge beyond 2D cultures.
- RANO Class 1 supramaximal resection (<5 cm³ FLAIR residual) yields 24-month median OS, outperforming maximal (19 mo) and submaximal (15 mo) resections.
- 5-ALA fluorescence guidance doubles complete resection rates (65% vs 36%) and improves 6-month PFS compared to white-light surgery.
- Tumor-treating fields plus temozolomide adds 2.7 months PFS and 4.9 months OS; cost-effectiveness under UK evaluation.
- Bevacizumab extends OS by only months and lacks European approval due to cost-ineffectiveness despite FDA clearance.
- Microfluidic ex vivo platforms maintain patient GBM tissue 8–12 days, enabling real-time cytokine profiling and resistance marker discovery.
For patients & families
When doctors treat aggressive brain tumors called glioblastomas, they combine surgery, radiation, and chemotherapy in a carefully planned sequence that has been the standard approach since 2005. The goal of surgery is to remove as much tumor as possible, because the amount removed directly affects how long patients live — removing nearly all visible tumor can lead to survival of about 19 months, while removing less may mean 15 months or fewer. Surgeons now have special tools to help them see tumor tissue more clearly during operations, including a drink patients take before surgery that makes cancer cells glow pink under blue light, helping doctors remove more tumor safely. Some patients stay awake during surgery so doctors can test their speech and movement in real time, protecting these important abilities while removing as much tumor as possible. After surgery, patients receive six weeks of daily radiation combined with chemotherapy, followed by additional chemotherapy cycles. Researchers are also testing newer approaches, including electric field therapy that disrupts cancer cell division and may add several months of survival when combined with standard chemotherapy. Scientists are developing laboratory models using actual patient tumor tissue to test new treatments more accurately before trying them in people.
When doctors treat aggressive brain tumors called glioblastomas, they combine surgery, radiation, and chemotherapy in a carefully planned sequence that has been the standard approach since 2005. The goal of surgery is to remove as much tumor as possible, because the amount removed directly affects how long patients live — removing nearly all visible tumor can lead to survival of about 19 months, while removing less may mean 15 months or fewer. Surgeons now have special tools to help them see tumor tissue more clearly during operations, including a drink patients take before surgery that makes cancer cells glow pink under blue light, helping doctors remove more tumor safely. Some patients stay awake during surgery so doctors can test their speech and movement in real time, protecting these important abilities while removing as much tumor as possible. After surgery, patients receive six weeks of daily radiation combined with chemotherapy, followed by additional chemotherapy cycles. Researchers are also testing newer approaches, including electric field therapy that disrupts cancer cell division and may add several months of survival when combined with standard chemotherapy. Scientists are developing laboratory models using actual patient tumor tissue to test new treatments more accurately before trying them in people.
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Essential Evidence for Glioblastoma: A Must-Know for Neurosurgery Exams
The Stupp protocol was published in 2005 as a landmark paper combining radiotherapy and chemotherapy with maximal surgical resection as the gold standard.
clinical1:07 ↗
The Stupp protocol radiotherapy consists of 60 Gy over 6 weeks, with 2 Gy daily Monday to Friday (30 fractions total).
clinical1:33 ↗
Concomitant temozolomide in the Stupp protocol is 75 mg daily for six weeks during radiotherapy.
clinical1:50 ↗
Adjuvant temozolomide is 150-200 mg per meter squared for the first 5 days of each 28-day cycle for a total of 6 cycles.
clinical1:57 ↗
RANO (Response Assessment in Neuro-Oncology) criteria classify resections based on residual contrast-enhancing tumor on T1 and non-contrast-enhancing hyperintense tissue on FLAIR, believed to represent glioblastoma infiltrative tissue.
clinical2:21 ↗
RANO Class 1 (supramaximal contrast-enhancing resection) is defined as 0 cubic centimeters of contrast-enhancing and less than 5 cubic centimeters of non-contrast-enhancing tissue postoperatively, with median overall survival of 24 months.
clinical3:09 ↗
Maximal surgical resection (leaving less than 1 cubic centimeter of contrast-enhancing tissue) leads to 19 months median overall survival.
clinical3:39 ↗
Submaximal contrast-enhancing resection (leaving less than 5 or more than 5 cubic centimeters of contrast-enhancing tissue) leads to 15 months overall survival, which is the gold standard quoted to patients.
clinical4:07 ↗
Biopsy only (Class 4, no tumor volume reduction) gives 10 months overall survival if the patient receives chemoradiotherapy.
clinical4:31 ↗
5-ALA crosses the blood-brain barrier and is converted in mitochondria to protoporphyrin IX, which accumulates in glioblastoma cells because ferrochelatase enzyme is less effective in these tumors.
clinical5:01 ↗
Protoporphyrin IX emits bright pink fluorescence when exposed to blue light microscope with wavelength 405 to 633 nanometers, allowing tumor visualization during surgery.
clinical5:46 ↗
5-ALA is administered as 1.5 g powder reconstituted in 50 mL drinking water (30 mg/mL oral solution) at a dosage of 20 mg per kg, given 2 to 4 hours before surgery.
clinical6:11 ↗
A randomized controlled trial of fluorescence-guided surgery with 5-ALA showed complete contrast-enhancing resection in 65% of patients using 5-ALA compared to 36% using white light.
clinical6:50 ↗
5-ALA fluorescence-guided surgery allows higher 6-month progression-free survival compared to white light surgery.
clinical7:10 ↗
Awake craniotomy offers significant advantages over general anesthesia for glioblastomas near eloquent brain by allowing real-time patient interaction to map and preserve critical functions like speech and movement.
clinical7:17 ↗
Awake craniotomy helps maximize tumor resection while minimizing postoperative neurological deficits, ultimately improving outcomes.
clinical7:36 ↗
Drawbacks of awake craniotomy include careful patient selection requirements, potential discomfort and anxiety during surgery, and longer operative times in some cases.
clinical7:45 ↗
Intraoperative MRI allows real-time imaging during surgery, enhancing the surgeon's ability to achieve maximal resections and increasing the rate of complete resections.
clinical8:02 ↗
Intraoperative MRI is not available in all hospitals and requires strong infrastructure and investment to install in neurosurgical theaters.
clinical8:18 ↗
Senft 2011 study on intraoperative MRI showed more patients had complete tumor resection than the control group, and postoperative neurological deficits did not differ between groups.
clinical8:33 ↗
VEGF (vascular endothelial growth factor) is responsible for stimulating endothelial cell proliferation and migration in the glioblastoma microenvironment.
clinical9:00 ↗
Bevacizumab reduces regression of existing microvessels and inhibits growth of new blood vessels, acting like dexamethasone but with more potent effect.
clinical9:10 ↗
Overall survival is increased by only a few months using bevacizumab alone.
clinical9:23 ↗
Bevacizumab is FDA approved in the United States but has not been proven cost-effective by the European Medicines Agency or UK NICE guidance.
guideline9:32 ↗
Tumor treating fields is a non-invasive modality applying mild electric fields that disturb cancer cell division.
clinical9:50 ↗
Tumor treating fields combined with temozolomide shows significant improvement in progression-free survival.
clinical9:50 ↗
There is currently a trial running in the UK to evaluate tumor treating fields effectiveness for inclusion in NICE guidelines.
clinical10:10 ↗
Tumor treating fields plus temozolomide versus temozolomide alone increased progression-free survival by 2.7 months and overall survival by 4.9 months.
clinical10:19 ↗
Our novel glioblastoma microfluidic platform
Traditional methods like animal models and 2D cell cultures fall short in replicating the complexity of glioblastoma microenvironment.
opinionAmmar0:16 ↗
Patient GBM tissue is the best option for closely mimicking the microenvironment of GBM and testing therapeutic interventions.
opinionAmmar0:34 ↗
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