Glioblastoma IDH-wildtype: An integrative review of pathophysiological mechanisms, diagnostic innovations, and emerging therapeutic modalities.

The most dangerous and fatal primary brain tumor in adults is glioblastoma multiforme/IDH wild-type glioblastoma (GBM), which is progressive, diffuse, and unresponsive to conventional treatment. Knowledge of the pathophysiology of GBM, genetic mutations, molecular signal transport paths, and tumor-microenvironment interactions is essential in improving clinical outcomes. Proper diagnosis is based on the most sophisticated neuroimaging methods and histopathologic examination, which makes it possible to grade the tumor accurately and establish treatment. Existing conventional therapy involves maximum resection followed by radiotherapy and chemotherapy; however, a considerable percentage of patients will eventually experience recurrence. The latest developments have been dedicated to those immunotherapy options, including immune checkpoint inhibitors, CAR-T cells, and dendritic cell vaccines, to augment anti-tumor immunity. To improve the bioavailability and targeted administration of therapeutic and chemotherapeutic drugs across the BBB, drug delivery systems utilizing nanoparticles have gained interest. Herbal and phytochemical compounds containing neuroprotective and anti-proliferative effects are also under investigation as adjunct therapy to regulate tumor growth and decrease side effects. The paper presents a critical summary of GBM, which incorporates pathophysiology, diagnostic modalities, traditional treatment interventions, and advanced treatment options. Through the emphasis on recent advances in the fields of immunotherapy, nanomedicine, and herbal interventions, this article highlights the possibility of using multimodality in achieving improved patient outcomes and provides the basis of future translational studies in the management of GBM.