Update in neurooncology

The standard of care in adult glioblastoma is tumour resection followed by concomitant radio /chemotherapy with temozolomide and 6 cycles of adjuvant temozolomide To improve this standard, clinical trials have evaluated/evaluate efficacy and toxicity of alengitide, an integrin antagonist inhibitors of tyro 1 sine kinases, of PKC beta and of neo angiogenesis among other substances In the recurrent situation intensified chemotherapy regimens are applied as well as bevacizumab, an anti body to the vascular endothelial growth factor For recurrent glioblastoma, results with small molecules have been disappointing For anaplastic glioma, WHO grade III, results of the NOA04 Mal have established a new standard There is no "standard' therapy for primary CNS lymphoma Methotrexate (MIX) based chemotherapy should be considered first A primary radiotherapy is not recommended its usefulness as "consolidating therapy after chemo could not be shown by a large prospective randomized trial Today s therapy of choice is a MIX based polychemotherapy In patients at age 60 years or younger this therapy is given in a curative approach In Germany there are well organized study groups If possible all patients should be treated within clinical trials