Newly diagnosed Glioblastoma Multiforme (GBM) during COVID-19 pandemic: changes in therapeutic approach to minimize in-hospital SARS-COV-2 contagion in pre-vaccine era


Valeria Internò
Roberta Rudà
Maria Chiara Sergi
Riccardo Soffietti
Camillo Porta


Glioblastoma Multiforme, Hypofractioned radiotherapy, Covid-19, In-hospital contagion, Multimodal therapy


COVID-19 pandemic revolutionized the way in which cancer patients are treated worldwide. Regarding neuro-oncological patients, usually considered frail and with lower life-expectancy in respect to other oncological patients, the international scientific community had to urgently reorganize the treatment approach in order to minimize the risk of in-hospital contagious. For GBM patients, adjuvant treatments have been evaluated with even much more attention with regard to the expected efficacy. As a consequence, an hypofractioned radiotherapy regimen has been preferred in order to reduce the daily hospital accesses and, especially in pMGMT unmethylated patients, chemotherapy with Temozolomide was avoided. Here, we made a comprehensive evaluation of the neurooncological community suggestions regarding GBM treatment in the pre-vaccine era of COVID-19 pandemic.


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1. Peng L, Zagorac S, Stebbing J. Managing patients with cancer in the COVID-19 era. Eur J Cancer. 2020;132:5-7. doi:10.1016/j.ejca.2020.03.028;
2. Liu C, Zhao Y, Okwan-Duodu D, Basho R, Cui X. COVID-19 in cancer patients: risk, clinical features, and management. Cancer Biol Med. 2020;17(3):519-527. doi:10.20892/j.issn.2095-3941.2020.0289
3. Cazzato, G.; Foti, C.; Colagrande, A.; Cimmino, A.; Scarcella, S.; Cicco, G.; Sablone, S.; Arezzo, F.; Romita, P.; Lettini, T.; Resta, L.; Ingravallo, G. Skin Manifestation of SARS-CoV-2: The Italian Experience. J. Clin. Med. 2021, 10, 1566.
4. Delgado-López PD, Corrales-García EM. Survival in glioblastoma: a review on the impact of treatment modalities. Clin Transl Oncol. 2016;18(11):1062-1071. doi:10.1007/s12094-016-1497-x;
5. Weinkove R, McQuilten ZK, Adler J, et al. Managing haematology and oncology patients during the COVID-19 pandemic: interim consensus guidance. Med J Aust. 2020;212(10):481-489. doi:10.5694/mja2.50607;
6. Pessina F, Navarria P, Bellu L, et al. Treatment of patients with glioma during the COVID-19 pandemic: what we learned and what we take home for the future. Neurosurg Focus. 2020;49(6):E10. doi:10.3171/2020.9.FOCUS20704;
7. Weller M, Preusser M. How we treat patients with brain tumour during the COVID-19 pandemic. ESMO Open. 2020;4(Suppl 2):e000789. doi:10.1136/esmoopen-2020-000789;
8. Bernhardt D, Wick W, Weiss SE, et al. Neuro-oncology Management During the COVID-19 Pandemic With a Focus on WHO Grade III and IV Gliomas [published online ahead of print, 2020 May 5]. Neuro Oncol. 2020;22(7):928-935. doi:10.1093/neuonc/noaa113;
9. Mrugala MM, Ostrom QT, Pressley SM, et al. The state of neuro-oncology during the COVID-19 pandemic: a worldwide assessment. Neurooncol Adv. 2021;3(1):vdab035. Published 2021 Feb 20. doi:10.1093/noajnl/vdab035;
10. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352(10):987-996. doi:10.1056/NEJMoa043330;
11. Perry JR, Laperriere N, O'Callaghan CJ, et al. Short-Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma. N Engl J Med. 2017;376(11):1027-1037. doi:10.1056/NEJMoa1611977;
12. Pellerino A, Bruno F, Internò V, Rudà R, Soffietti R. Current clinical management of elderly patients with glioma. Expert Rev Anticancer Ther. 2020;20(12):1037-1048. doi:10.1080/14737140.2020.1828867;
13. Gay HA, Santiago R, Gil B, et al. Lessons Learned From Hurricane Maria in Puerto Rico: Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients. Pract Radiat Oncol. 2019;9(5):305-321. doi:10.1016/j.prro.2019.03.007;
14. Hegi ME, Stupp R. Withholding temozolomide in glioblastoma patients with unmethylated MGMT promoter--still a dilemma? Neuro Oncol. 2015;17(11): 1425-1427. doi:10.1093/neuonc/nov198
15. Kamson DO, Grossman SA. The Role of Temozolomide in Patients With Newly Diagnosed Wild-Type IDH, Unmethylated MGMTp Glioblastoma During the COVID-19 Pandemic. JAMA Oncol. 2021;7(5):675-676. doi:10.1001/jamaoncol.2020.6732.
16. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020;395(10223):473-475. doi:10.1016/S0140-6736(20)30317-2