A modern approach to glioblastoma using temozolomide and nanoparticles carrier drug: a standard care of combination therapy and treatment.

Glioblastoma (GBM) is the most fatal primary brain tumor in adults, characterized by fast development, resistance to standard treatments, and a poor prognosis. Although extensive treatments in surgery, radiation, and chemotherapy, resistance to therapy and recurrence persist as unavoidable outcomes. Temozolomide (TMZ), an oral alkylating drug, represents the current standard chemotherapy for GBM. However, its therapeutic effectiveness is severely restricted by its inability to pass through the blood-brain barrier (BBB) properly, its relatively short systemic half-life, and the development of resistance mechanisms, especially those related to O6-methylguanine-DNA methyltransferase (MGMT) repair activity. Nanoparticles (NPs)-based drug delivery devices represent a significant improvement in GBM therapies, providing a viable solution to the challenges of conventional TMZ therapy. Nanocarriers enhance medication solubility, facilitate BBB penetration, target tumor-specific receptors, and minimize general toxicity. This review assesses the function of TMZ in the treatment of GBM, the processes underlying drug resistance, and the potential of nanotechnology to enhance the effectiveness of TMZ. Additionally, we would like to discuss the multifunctional and co-delivery systems of TMZ, along with their pre-clinical and clinical successes and the challenges in bringing these medicines into clinical practice. Therefore, the incorporation of TMZ with nanoparticle-mediated delivery systems signifies a transformative advancement in GBM treatment, offering the opportunity for personalized therapy, overcoming resistance, and markedly enhancing patient survival rates.