Despite advances in understanding the molecular causes and effects of glioblastomas, or GBM, it remains the most common, treatment-resistant, and deadliest type of brain cancer.
GBM Awareness Day falls on July 21 — a day when researchers, patients and caregivers put a spotlight on this devastating condition to help improve education and remember those who were stricken.
“Despite all the advancements in surgery, radiation and chemotherapy, the outcomes for patients with glioblastoma still remain dismal,” said medical oncologist Manmeet Ahluwalia, M.D.,  M.B.A, an internationally recognized clinical investigator with Miami Cancer Institute , who specializes in the treatment of brain tumors and brain metastases. “What it means is that we have a lot of work to be done to help our patients live longer — and with a better quality of life.”
(Watch video: Hear from medical oncologist Manmeet Ahluwalia, M.D., M.B.A, an internationally recognized clinical investigator with Miami Cancer Institute. Video by Dylan Kyle.)
Miami Cancer Institute collaborates with neurosurgeons at Miami Neuroscience Institute, also part of Baptist Health, to treat patients with glioblastoma. Neurosurgeons Vitaly Siomin, M.D. , and Michael McDermott, M.D. , chief medical executive of Miami Neuroscience Institute , lead the brain tumor teams.
Dr. Siomin says that it’s virtually impossible to remove glioblastoma tumor cells entirely. “Glioblastoma is one of the most malignant brain cancers,” he says. “Unfortunately, it often leads to very unfavorable outcomes.”
Glioblastoma is a malignant brain tumor that develops from a specific type of brain cell called an astrocyte. GBMs are often very aggressive, spreading into surrounding brain tissue. Signs and symptoms, such as headache, nausea, vomiting and/or drowsiness, may develop when the tumor begins to put excess pressure on the brain. GBMs may also create other symptoms, depending on the size and location of the tumor.
Glioblastoma is typically diagnosed after a physical exam that focuses on symptoms and imaging studies, such as computed tomography (CT) and/or magnetic resonance imaging (MRI). In most cases, the precise underlying cause of glioblastoma is unknown. In rare cases, they can occur in people with certain genetic syndromes.
There is no cure for glioblastoma. Treatment includes surgery, radiation therapy and medical therapy that includes chemotherapy. The best surgical approach for each person depends on several factors, such as the size and location of the tumor;; and the affected person’s performance status and overall health. There is a huge emphasis at Miami Cancer Institute to treat with these patients on clinical trials as recommended by NCCN guidelines.
Immunotherapy is an advanced cancer treatment  that helps boost your body’s immune system to fight cancer. Miami Cancer Institute offers different types of immune therapies that help a patient’s immune system identify and attack cancer cells. Treatment may use your own cells or donor cells, as well as antibodies or vaccines.
“Immunotherapy based approaches involve multiple categories,” explains Dr. Ahluwalia. “One of them can be vaccine-based approaches, where we give patients vaccines which go after these particular peptides (chain of amino acids) that are expressed by the tumor. So, we can build up the immune system to go after the tumor.
“Another one involves genetically engineered viruses where we operate on these patients. At the time of surgery, we put in the resection cavity injections of these genetically engineered viruses which can then go and selectively invade cancer cells. Then another category in immunotherapies involves drugs which boosts the immune system to go and kill the cancer. Additionally, we can use adoptive cell therapy, also known as cellular immunotherapy, which is a form of treatment that uses the cells of our immune system to eliminate cancer.”
The primary recommendation for patients with glioblastoma is to get treatment through clinical trials (preferred option) or standard of care, said Dr. Ahluwalia.
“At Miami cancer Institute, we believe in a team-based approach in taking care of our patients with glioblastoma, just like any complex cancer,” explains Dr. Ahluwalia. “So, a team consisting of neurosurgeons, radiation oncologist, as well as a neuro-oncologist and medical oncologist, who only treat patients with brain tumors on a daily basis, work together in taking care of such patients. We have a tumor board where we discuss care and treatment plans for each and every patient.”
Every year, about 13,000 people will be diagnosed with glioblastoma in the United States.
“Most patients survive 15 to 18 months,” said Dr. Ahluwalia. “Hence, when someone is diagnosed with glioblastoma, we always recommend that patients seek treatment at a center of excellence such as Miami cancer Institute. Here, we work in a team-based approach with professionals who have had special training and expertise in treatment of patients with brain tumors. We also like to utilize clinical trials as a way of providing best care to our patients at the Institute for glioblastoma and other brain tumors.”