Glioblastoma is an aggressive type of brain cancer. Standard treatment usually includes three weeks of radiation therapy alone or combined with chemotherapy using Temozolomide. After a four- to six-week break, more Temozolomide chemotherapy is usually given. However, some tumors have a marker ("unmethylated MGMT") that predicts the usual chemotherapy won't work. Because of this, this project will explore other treatment options to help slow the disease and improve survival. In this study, the same chemotherapy (Temozolomide) normally given after radiation therapy for glioblastoma. The only difference is that it will be given with a modified regimen.
Age ≥65 years.
Histopathologically confirmed newly diagnosed WHO grade 4, IDH wild-type GBM
Unmethylated MGMT promoter, according to local assessment
Completed treatment with 40 Gy in 15 fractions over three weeks, with concurrent TMZ, within six weeks prior to enrollment
Diffuse leptomeningeal involvement at the time of diagnosis.
Inability to undergo contrast-enhanced magnetic resonance imaging (MRI)
Known hypersensitivity to TMZ components or Dacarbazine
Severe myelosuppression