Virtual Molecular Tumor Board

Levine Cancer Institute
Presented by: Dr. Ashley Sumrall
Patient: Glioblastoma

Initial Diagnosis and Treatment

A 46-year-old man presented to the ED in Mexico with a 6-week history of left-sided numbness and tingling, slurred speech and increasing facial weakness. He underwent a CT scan with and without contrast that demonstrated a right frontal parietal mass with vasogenic edema. He was placed on levetiracetam, and arrangements were made to have him transported back to the United States for neurosurgical evaluation.

• December 2015: Frontal craniotomy with stereotactic volumetric resection of tumor using microsurgical technique
• Unmethylated glioblastoma (WHO grade 4)
• IDH1 and IDH2 negative
• 1p/19q negative
• Tissue sent for molecular testing
• January 2016 to February 2016: Radiation therapy (60 Gy/30 fractions) with concurrent temozolomide (Temodar, Merck)
• March 2016: Possible pseudoprogression noted
• April 2016: Stable scan
• May 2016: Initiate maintenance temozolomide, planned 6 to 12 cycles
• October 2016: Progressive disease