



































Special Edition: Junior Clinical Research (2022), Vol. 2 No. S2 
 https://doi.org/10.47488/dhrp.v2iS2.63 

 

 

 
 
 DHR Proceedings ǀ http://dhrproceedings.org  30 2022, Vol. 2 No. S2 30-35 

 

 

COMMENTARY 

Overview of Glioblastoma 
 

Alvaro Martinez1,2, Cassandra Maldonado1,2, Galilea De Leon1,2, Jennifer Agustin1,2, Yolanda 

Montelongo1,2, Amber Ramirez1,3, Obed Alvarez1,3, Clarissa Gomez1,4, Alec Kanhere1,4, Marlina 

Perez1,5  

 
12nd Annual Junior Clinical Research Internship, South Texas Academy for Education & Training in Research, DHR Health 

Institute for Research & Development  
2Juarez- Lincoln High School, Mission TX  
3McAllen High School, McAllen TX  
4Roma High School, Roma TX  
5Lyford High School, Lyford TX 

 

All correspondence should be addressed to Program Director, 2nd Annual Junior Clinical Research Internship Program, DHR 

Health Institute for Research & Development, 5323 S McColl Road, Edinburg Texas, 78539 

 

Received 07/21/2022 

Accepted for publication 08/03/2022 

Published 08/03/2022 

 

 
 

 

Introduction  
 

Glioblastoma multiforme (GBM), a rapidly 

developing and highly aggressive brain tumor, 

accounts for more than 49 percent of all primary 

malignant brain tumors (1). Through the extensive 

research of medical professionals, the scientific 

community has gained a deeper understanding of 

GBM, and thus discovered common symptoms, 

medical treatments, and distinct therapies to attempt to 

treat the patient. Treatment for GBM is challenging 

due to the disease's innate resistance to conventional 

therapy and its propensity for invasive behavior; as a 

result, more effective neuro-oncological and 

neurosurgical therapies are required (2). 

 

History  

 

Discovery  
 

As one of the most complex brain tumors, it 

isn't a surprise that glioblastomas have a long line of 

history. Although the origin of these brain tumors is 

unknown, records that indicate their existence date 

back to the 1800s. In 1800 and 1804, British scientific 

reports by Burns and Abernethy displayed the first 

ever recorded glioblastomas (3). In 1863, Rudolf 

Virchow, a German physician and founder of social 

medicine, provided the first comprehensive 

histomorphological description of this fast-growing 

malignant tumor (3). Virchow was able to demonstrate 

the tumor's glial origin which ultimately created the 

steppingstone for future scientific researchers.  

 

Researchers  
 

Since the initial discovery of GBM, there 

have been plenty of researchers that continue to 

investigate the mystery of this deadly brain tumor. In 

1914 American Pathologist, Frank Burr Mallory, was 

credited for coining the term Glioblastoma 

Multiforme. In 1926, researchers Percival Bailey and 

Harvey Cushing established the basis of modern 

classification from gliomas and glioblastomas, which 

they called GBM. Scherer and Kernohan were the 

most prolific researchers between the years of 1934 

and 1941 and postulated some of the clinic-

morphological aspects of glioblastomas (4). 

 

 



Martinez, et al. Overview of Glioblastoma 

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Glioblastoma Formation  
 

Glioblastoma is a cancerous tumor that 

develops in the brain. They form from astrocytes 

which are star-shaped cells that protect and provide 

nutrients to the brain. It’s common for glioblastoma to 

grow in the brainstem and cerebellum for most adults. 

These tumors can also metastasize in multiple areas of 

the brain, and in some rare cases it can even grow in 

other parts of the body (5). 

 

Types of GBM 
 

Glioblastoma has 2 types, primary 

glioblastoma and secondary glioblastoma. Primary 

glioblastoma is more common for older people. It’s 

also the common type to have, and with this, your life 

expectancy will most likely be shortened. Secondary 

glioblastoma mainly targets younger individuals. It 

forms from a low-grade glioma which can grow in 

almost any part of the brain and occasionally in the 

spinal cord. The survival rate for this type tends to be 

higher than the primary glioblastoma (5). 

 

Similarities and Differences  
 

Like any kind of cancer found in the body, 

there are many differences and similarities between 

these malignant tumors. Glioblastomas are a type of 

glioma, which is one of the most common types of 

brain tumors. With this classification it can be inferred 

that these tumors are quite similar. The only difference 

between the two is the severity of the tumor and grade. 

On the other hand, glioblastomas can be far more 

complex than other types of brain tumors and can 

show symptoms rather quickly. All brain tumors range 

from a grade scale between 1 and 4 (4 being the most 

dangerous and 1being the least dangerous). Compared 

to the other brain cancers, all glioblastomas are 

considered grade IV brain tumors. The reason for this 

is that they have the most unusual looking cells 

ultimately making them the most aggressive (6). 

 

Prognosis  
 

As of now the prognosis states that there is no 

possible cure for GBM. Treatments are available for 

patients to keep the tumor in control for a couple of 

months, and if possible, even years. As glioblastoma 

continues to grow it creates microscopic branches that 

can spread to various parts of the brain, which can 

make it extremely difficult to remove through surgery. 

Additionally, a single tumor contains different types of 

cells which can make it almost impossible to treat the 

whole tumor. For instance, if a drug is being used to 

treat the tumor, it will only kill a certain cell, not all of 

them (7). 

 

GBM Prevalence  

 

Rate of GBM  
 

Glioblastoma multiforme (GBM) is the 

aggressive, most common brain tumor found in arising 

adults (8). Every year, more than 13,000 American 

citizens are diagnosed with glioblastoma, and that’s 

not taking into consideration the amount of people 

who don’t participate in monthly checkups. 

Glioblastoma has an already low survival rate of 40% 

within the first year. While things may look good in 

the beginning, chances decrease to 17% in just the 

second year, and to a 6.8% chance at the end of 5 

years. This cancer has a terrifying population 

percentage, accounting for almost 50% of all brain 

cancer cases. In the United States on average there is 

a slightly higher rate in men than women affected by 

Glioblastoma. With that Caucasians compared to other 

ethnic groups such as African Americans, Asians, and 

American Indians have a greater chance of diagnosis 

(9).  

 

Gender Distribution  
 

In the gender population, males have a faster 

exposure to the cancerous cell than females, due to 

their series of genetic alterations and exposure to 

growth factors (9). Glioblastoma is more common in 

older males and begins around the age of 64. Although 

it only begins at this age, it worsens and gets more fatal 

as the years pass. Although GBM is found more 

frequently in men than women, recent studies have 

shown that females experience a higher intensity in 

symptoms and their tumors tend to be larger than those 

in males. The reason for these statistics is still 

unknown, but researchers are continuing to discover 

new information about these tumors. 

 

Race/ Ethnicity  
 

Just like age and gender, a patient's race or 

ethnicity can be an additional factor that may give 

more information on survival and instances (10). In 

research studies based on race and ethnicities, it has 

been found that Asians or Pacific Islanders have the 

highest 1- year to 5-year survival rate (67.1%, 10.1%). 

African Americans follow with a 1-year rate of 60.9% 

and a 5-year rate of 9.9%. Hispanics are second to last 

with a rate of 60.4% in the first year and 9.5% in the 



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fifth year. Lastly, non- Hispanic whites have the 

lowest survival rate of 57.2% and 6.6% in the 1-to-5-

year period. Although race and ethnicity are important 

to factor in a patient's diagnosis of GBM, there is still 

extensive research being done in this field for future 

data. 

 

Causes & Symptoms  
 

Located either in the brain or spinal cord, this 

disease comes with many effects and critical 

symptoms including both psychiatric and neurological 

(8).  

 

Neurological Symptoms  
 

Neurological symptoms are relatively shown 

during growth and expansion of the tumor. Around 40 

to 60 percent of patients with glioblastomas are prone 

to show neurological symptoms which include 

headaches, disorientation, vomiting, seizures, memory 

loss, and speech difficulties (8). The effect for this is 

due to the increased intracranial pressure in the frontal 

lobe and corpus callosum (8). The reason being, of 

these neurological symptoms are because of the 

amount of swelling due to the tumor and the desired 

room when growing (11). The tumor will push on the 

brain during a fast-spreading process that affects any 

nearby brain tissue (11).  

 

Psychiatriatric Symptoms  
 

Most cases of glioblastoma show 

psychiatriatric symptoms and 62 percent of these cases 

are seen from middle aged to older patients (8). Some 

primary psychiatriatric symptoms include depression, 

anxiety, manic-like states, and mood disorders (8). As 

much as 35% of patients manifest psychiatrist 

symptoms and are prone to be psychotic, have 

schizophrenia, resist treatment, and hallucinate (8). 

The reason for patients with GBM possessing these 

symptoms is due to tumors predominantly being 

pushed up against the temporal lobes ultimately 

affecting the frontal lobe (8).  

 

Genetics 
 

 The root cause for glioblastoma is 

unfortunately unknown and it has shown not to be 

inherited through genetics (12). Although it is 

classified as an idiopathic tumor, some individuals 

with neurofibromatosis type 1, (a genetic cancer 

syndrome), Turcot syndrome, and Li Fraumeni 

syndrome can elevate their chances for this disease 

(13). 

 

Diagnosis  
 

Due to glioblastoma being classified as a 

stage four cancer, it is one of the most aggressive and 

rapidly growing brain tumors (14). If a patient has 

GBM they will begin to feel symptoms such as 

headaches, speech, vision, hearing, thinking 

impairment, and more. A very common symptom in 

patients is losing vocabulary or forgetting thoughts 

easily. A way of finding Glioblastomas is by taking an 

MRI. When the patient feels these symptoms, they will 

have an MRI taken to see whether there is a tumor in 

the first place and if they need surgery. In other cases, 

a surgical biopsy is needed to see if the mass detected 

is a Glioblastoma or another type of brain tumor. For 

most patients, the median time it takes to receive a 

diagnosis is around 330 days; that is almost one full 

year (15). The time period for diagnosis does range 

between 156 to 776 days depending on how long it 

takes an individual to be tested. Unfortunately, the 

reason it takes a long period of time for an individual 

to be diagnosed with GBM is because most patients 
don’t feel symptoms until 100 days after the tumor 

begins to develop. Although early detection remains 

difficult, new technologies are being made to help 

identify early stages of glioblastoma. Developments 

such as liquid biopsy and serum biomarker may allow 

for early diagnosis and early treatment in future cases 

of glioblastoma. 

 

Treatment/Therapy 
 

The typical course of treatment for a GBM 

entails surgery, daily radiation, and oral chemotherapy 

administered over the course of six and a half weeks, 

followed by a six-month oral chemotherapy regimen 

administered five days each month (16). Currently, 

surgery to remove as much of the tumor as possible is 

the best course of action for glioblastoma, which is 

then followed by a chemotherapy and radiotherapy 

regimen.  

 

Treatment History  
 

Many hospitals and research teams have 

pursued the study of Glioblastomas trying to better 

treat it and ultimately find a cure. Although this certain 

tumor is very complex, many breakthrough 

discoveries have been made. In 1888, physician 

Byrom Bramwell was one of the first physicians to 

point out the surgical challenge that these tumors 



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brought to the table. He explained that without 

microscopical examination, it would be quite 

impossible to spot the transition between the tumorous 

tissue and normal brain tissue. Furthermore, in our 

society today many institutes have partnered with 

universities around the country in hopes to advance 

medical care for patients who suffer from 

glioblastomas. The Translational Center of Excellence 

(TCE) in the Abramson Cancer Center at Penn 

Medicine has focused on the issues of GBM and have 

continued to create opportunities to revolutionize 

treatment. The Penn Medicine team is an international 

leader in researching and treating Glioblastoma and 

have made game-changing discoveries. They have 

ushered in a new era of cellular therapies that treat 

cancer with a patient’s immune system (17). In 2005, 

Medical Director at the Lou and Jean Malnati Brain 

Tumor Institute, Roger Stupp, developed a worldwide 

standard care for Glioblastoma known as the Stupp 

protocol. His findings in better treatment and new 

ways of treatment have changed the survival ratio of 

patients from 1 in 10 that lived longer than two years 

after diagnosis to now more than 1 in 4 (18). Although 

there is still much to learn about Glioblastomas, there 

have been great advancements in treatments. It is only 

a matter of time before scientific researchers find a 

cure.  

 

Adjuvant Therapy  
 

Patients with glioblastoma begin 

chemotherapy 2 to 4 weeks following surgery. Either 

along with radiation therapy or soon after it (19). 

GBMs and other advanced brain tumors are frequently 

treated with temozolomide, a chemotherapeutic 

medication that the FDA approved in 2013 (16). The 

medication slows the growth of tumors and is 

administered orally. Usually, the medication is taken 

daily during radiation therapy and for six cycles after 

radiation during the maintenance phase (20). 

Temozolomide not only has direct anticancer actions 

but also has immunomodulatory qualities (21). 

Chemotherapy's effects are influenced by the drug's 

method of action, dosage, and host immune system 

(21).  

 

And then of course, there’s radiation. 

Radiation therapy for glioblastoma involves directing 

X-rays, gamma rays, or photons at a tumor to kill 

malignant cells (22). The tumor shrinks as cancerous 

cells are cleared by the body's immune system, which 

relieves pressure on the brain. If a surgeon decides that 

removing a tumor would be too dangerous, it may be 

used as a primary treatment (16). It may also be 

performed following surgery to eliminate any 

cancerous cells that the surgeon was unable to see or 

reach. 

 

Surgery  
 

For surgery, the neurosurgeon will attempt to 

remove the majority of the tumor (16). However, it is 

impossible to entirely eradicate GBMs due to a zone 

of invading tumor cells that assault the tissues around 

the tumor. The neurosurgeon may also insert 

medicated wafers into the brain. Over time, these 

wafers naturally break down and deliver 

chemotherapy medications into the tumor area (16).  

 

Clinical Trials  
 

All these wonderful treatments, but how 

effective are they? is the real question. Well, the 

current standard of care for glioblastoma multiforme 

is successful and has extended survival times for more 

patients to two, three, and even four years. Sadly, this 

treatment is not curative (16). Which basically means 

that it does not terminate every single tumor cell. 

However, the outlooks and future for patients with 

Glioblastoma are expected to improve. 

 

Clinicians and researchers are developing 

new trials in an attempt to improve the survival rate of 

patients who have Glioblastoma. A great example of 

this would be this fairly new clinical trial from a team 

at the University of Michigan Rogel Cancer Center. 

This certain clinical trial began in august of 2020 and 

is led by Daniel Wahl, M.D., Ph.D. They hope to 

achieve and succeed where several other Glioblastoma 

treatments have failed. This trial still has a very long 

way to go (23). In a brilliant ongoing clinical trial 

which is led by Dr. Andrew B. Lassman, the John 

Harris Associate Professor of Neurology at Columbia 

University Vagelos College of Physicians and 

Surgeons and head of the Neuro-Oncology Division at 

Columbia University Irving Medical Center/New 

York-Presbyterian, observed tumor reduction in 

nearly a third of patients with recurrent glioblastoma, 

an aggressive brain cancer while using selinexor, the 

first of a new class of anticancer drugs. (24). These are 

only a few of the several ongoing clinical trials 

attempting to alter the course of glioblastoma patients' 

futures. 

 

Mental Health  
 

Another important aspect that is very crucial 

to remember is that this patient is not only battling a 



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deadly unforgiving cancer, but they are also 

undergoing emotional distress such as anxiety and 

depression. Any cancer really can have this effect. 

This is why it is crucial that you care for your patient 

and have some empathy. To assist patients in coping 

with the emotional distress and stress caused by cancer 

and its treatment, palliative care teams frequently 

include social workers and/or other mental health 

specialists. To improve the general quality of life for 

cancer patients, therapists and counselors can provide 

their services in person or online (25). 

 

Conclusion  
 

Despite improvements in our understanding 

of GBM, its inherent invasiveness and resistance to 

standard treatments makes it extremely difficult to find 

a cure. It is important to educate healthcare and local 

communities on the importance of the severity of 

glioblastomas to inculcate the urgency in patients to 

seek medical attention once neurological symptoms 

are detected. In doing so, the patient’s overall physical 

and emotional well-being may be exceptionally 

improved. As experts continue to advance their 

medical care for those suffering from GBM, exposing 
its severity to local communities yields the patient a 

better prognosis. 

 

Acknowledgments 

 

Dr. Monica Betancourt-Garcia, MD, Scientific 

Director; Melissa Eddie, MS, Program Manager; 

Xochitl Lopez, BS, Program Coordinator 

 

Funding 

 

Funded by DHR Health Institute for Research & 

Development; DHR Health; Region One ESC 

GEARUP College Ready, Career Set! Region One 

ESC GEARUP College Now, Career Connected and 

Region One ESC PATHS 

 

 

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