Het landschap van combinatie therapien voor glioblastoom

We demonstrate in this thesis how new targets can be identified and highlight the challenges that lie in front of us when trying to translate these steps toward the clinic. We conclude that the blood-brain barrier, PD/PK of drugs, and therapy resistance are still major challenges and explain the limited improvement in treatment options for patients with GBM. First, GBM is a diffuse glioma located in the brain where the blood-brain barrier prevents the crossing of drugs and thereby limits the efficacy of treatment. Second, inter- and intratumoral heterogeneity have been observed in GBM leading to different cellular subpopulations with distinctive genetic profiles. Hence, treating these subpopulations with targeted drugs allows until now still survival of certain subpopulations that are not sensitive to this treatment. Lastly, therapy resistance is often seen in GBM patients and is probably related to intratumoral heterogeneity, but the intrinsic molecular mechanism is still not fully understood. Together they lead to the inevitable recurrence of the tumor.