Novel radiation-enhancing agents in malignant gliomas

Malignant gliomas represent among the most aggressive of all known human neoplasms. These tumors show high levels of resistance to conventional therapies (ie, surgery, radiation, and chemotherapy). For many decades, significant improvements in clinical outcomes of newly diagnosed glioblastoma (GBM) patients have not been observed until recently. A landmark European Organization for Research and Treatment of Cancer (EORTC) phase III study showed significant improvements in median and 2-year survivals in newly diagnosed GBM patients treated with a combination of radiation and temozolomide chemotherapy versus radiation alone. The results of this study have certainly defined practice standards for this patient population. This article will review the role of both traditional nitrosurea-based and newer-generation chemotherapeutic and biotherapeutic agents when combined with radiation therapy for the treatment of malignant glioma patients.