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Imago glioblastomatis cum falcem cerebri amota propter diffusionem tumorem.
**Glioblastoma multiforme** sive **Glioblastoma** est species cancri cerebri, qui haud sanabilis est. Nam quinque annos post morbum inventum, solum 2 centesimae hominum hoc cancro laborantium supersunt. Causae huius morbi adhuc ignotae sunt.

Tractatio difficile restat, in parte diversitate *microcircumiectorum immunologicorum* cancri. Adhuc therapiae adversus cancri angiogenesem ineffectivae videbantur.

Pathophysiologia
----------------

In morbi cursu cellulae gliomata numero crescunt. Microcircumiectorum planitie diversitas insolita inter cellulas neoplasticas et non neoplasticas emergit. Abundissime sunt cellulae generis *tumori associatorum macrophagocytorum* (TAM), ergo cellulae systematis immunitatis innati, quae 40% massa cancri constituunt.

Symptomata
----------

Generalia indefinitivaque symptomata sunt convulsiones novae vel adhuc incognitae, capitis dolor, nausea, vomitus, memoriae spoliatio, ac alia symptomata neurologica circumscripta, quamquam spectrum symptomatum de tumoris loco pendat; per haec symptomata se attollere aut celerrime queant, aut longe occultare.

Classificatio glioblastomatum
-----------------------------

Classificatio ordinis mundi sanitarii (*WHO*) anni 2016 notat:

* Glioblastomata IDH1 mutanda
	+ Glioblastoma cellularum gigantium
	+ Gliosarcoma
	+ Glioblastoma epitheloidum
* Glioblastoma IDH1, typi ferocis
* Glioblastoma non alibi specificatum

Comparatio classificationis 2016 cum veta 2017 criteria genetica addita esse ostendit: IDH mutandum et typum ferocem.

Tractatio
---------

Adhuc sanatio glioblastomatis restat difficilis et estimatur tumorem recursurum esse. Therapia per resectionem neurochirurgicam, radiotherapiam, chemotherapiam, et medicamentum temozolomidi fit.

### Formae tractationis adhuc vel non generaliter probatae

In scientia hodierna medica novas tractationis formas investigantur ut, verbi gratia, *inhibitores receptorii EphA3*, *inhibitores EGFR* (includens anticorpora monoclonalia), *inhibitores VEGF*.

#### Inhibitores VEGF

Glioblastomatibus multiformibus permulta vasa sanguinea sunt, ergo inhibitionem angiogenesis (generationis novorum vasorum sanguineorum) investigabatur. In angiogenesi *factor crescentis endothelialis vascularis* (*VEGF*) velut receptorium suum, receptorium VEGF (*VEGFR*), momenta habent. Adhuc tamen numquam strategia contra angiogenesem incrementum tumoris inhibere potuit. Effectus inhibitoris kinasum tyrosini Regorafenib incerti restant.

#### Interleukin 12

Interleukinum 12 (IL-12) est cytokinum cum effectibus contra cancrum. Nuper CHIOCCA et al. textui gliobastomatis genum IL-12 generantem applicaverunt.

Notae
-----

1. ↑  "Glioblastoma and Malignant Astrocytoma". American Brain Tumour Association (ABTA)
2. ↑  Bleeker, Fonnet E.; Molenaar, Remco J.; Leenstra, Sieger (2012). "Recent advances in the molecular understanding of glioblastoma". *Journal of Neuro-Oncology* **108** (1): 11–27
3. ↑  De Leo A. Ugolini A. Veglia F. (Dec 2020). "Myeloid Cells in Glioblastoma Microenvironment". *Cells* **10** (1): 18
4. ↑  Ameratunga M. Pavlakis N. et al. (Nov 2018). "Anti-angiogenic therapy for high-grade glioma". *The Cochrane database of systematic reviews* **11** (11): CD008218
5. ↑  Buonfiglioli A. Hambardzumyan D. (Mar 2021). "Macrophages and microglia: the cerberus of glioblastoma". *Acta neuropathologica communications* **9** (1): 54
6. ↑  Alifieris C. Trafalis D. T. (Aug 2015). "Glioblastoma multiforme: Pathogenesis and Treatment". *Pharmacology & Treatment* **152** (63-82)
7. ↑  Komori T. (2017). "The 2016 WHO Classification of Tumours of the Central Nervous System: The Major Points of Revision". *Neurologia medico-chirurgica* **57** (7): 301-11
8. ↑  Gallego O. (Aug 2015). "Nonsurgical treatment of recurrent glioblastoma". *Current oncology* **22** (4): e273-81
9. ↑  Taylor O. G. Brzozowski J. S. Skelding K. A. (Sep 2019). "Glioblastoma Multiforme: An Overview of Emerging Therapeutic Targets". *Frontiers in oncology* **9**: 963 .
10. ↑  Lombardi G. De Salvo G. L. Brandes A. A. Eoli M. Rudà R. Faedi M. Lolli I. Pace A. et al. (Ian 2019). "Regorafenib compared with lomustine in patients with relapsed glioblastoma (REGOMA): a multicentre, open-label, randomised, controlled, phase 2 Trial". *Lancet oncology* **20** (1): 110-9
11. ↑  Chiocca E. A. Yu J. S. Lukas R. V. Solomon I. H. Ligon K. L. Nakashima H. Triggs D. A. Reardon D. A. Wen P. (Aug 2019). "Regulatable interleukin-12 gene therapy in patients with recurrent high-grade glioma: Results of a phase 1 Trial". *Science translational medicine* **11** (505): eaaw5680 .

Nexus interni
-------------

* Astrocytoma
* Cellula glialis