PREFACE
Glioblastoma: Translating Scientific
Advances to Innovative Therapy
Steven Brem, MD, Editor Kalil G. Abdullah, MD, Editor
Our main business is not to see what lies
dimly at a distance, but to do what clearly
lies at hand
—Thomas Carlyle
In your hands you will find in this unique volume a
current and comprehensive look at glioblastoma,
and emerge with an enhanced understanding
that reflects an explosion of information and
innovation. There has been an unmet need for a
single, systematic treatise on glioblastoma. With
the enthusiastic participation of luminaries in
neuro-oncology, we redefine the numerous fac-
ets of glioblastoma, from its history, epidemi-
ology, and pathogenesis to principles of
surgery, radiation therapy, and chemotherapy.
The early detection of glioblastoma through bio-
markers and response to therapy promises to
inform future clinical trials and accelerate the
pace of discovery to continuously increase sur-
vival. We include novel approaches such as anti-
angiogenic therapy, T-cell immunotherapy, laser
interstitial thermocoagulation, electric field ther-
apy, and local therapies.
Glioblastoma has long been refractory to
treatment because of its molecular, cellular, and
spatial heterogeneity, depicted by its original sur-
name multiforme. Accordingly, the book distills
the multiple dimensions of glioblastoma in a
rare collection of brief, but informative, sum-
maries of classic and emerging modalities to
tackle glioblastoma. The pieces of the puzzle
are here for the reader to digest and discover.
This robust, dynamic, interdisciplinary approach
paves the way for further breakthroughs to
enhance survival and quality of life.
For those entering the field, or for seasoned
clinicians and researchers, there is a sense of
genuine excitement this year. President Barack
Obama declared a “cancer moonshot” to harness
advances in genomics, informatics, and immuno-
therapy towards the ultimate cure of cancer.
Vice-President Joe Biden has traveled across
the United States to speak with leaders in the
war against cancer. There is a feeling of
increasing optimism that this war is winnable.
Data presented on epidemiology and survival
demonstrate the basis for optimism and the prog-
ress made to tame glioblastoma. Included in this
text are chapters on socioeconomics that high-
light the challenges we face in providing the
most advanced care in the context of a shifting
healthcare landscape. Dr. Duffau’s chapter on
neuroplasticity provides insight and hope as we
move from scientific discovery to functional re-
covery. Taken together, the reader will develop
a profound understanding of glioblastoma from
multiple vantage points. We believe the reader
will find the best work of the most established
thinkers, scientists, and surgeons in our field.
We hope you enjoy these gems as as much as
we have. ix
x Glioblastoma: Translating Scientific Advances to Innovative Therapy

We thank all the authors who so kindly contrib- the inspiration, strength, and purpose to treat
uted these erudite and well-researched chapters. this disease. They are our heroes, and we dedi-
We are ever grateful to Charlotta Kryhl and Alison cate this book to them.
Swety at Elsevier for their professionalism and Most sincerely,
timely publication of this book.
We thank our families and loved ones; Dr.
Steven Brem, MD
Brem especially thanks his wife, Hana, an angel
Department of Neurosurgery
throughout his career, including during the time
Hospital of the University of Pennsylvania
to prepare this book. We also thank our patients
Philadelphia, PA, USA
and their families, who have been touched by
glioblastoma. As with all cancer, glioblastoma Kalil G. Abdullah, MD
disrupts not only the life of the patient, but the Department of Neurosurgery
lives of the family, loved ones, and community. Hospital of the University of Pennsylvania
Each and every day our patients provide us with Philadelphia, PA, USA