Pharmacotherapeutic Approaches in Glioblastoma: Pathophysiology and Role of Clinical Pharmacists in Optimizing Patient Care

Abstract

The most aggressive and prevalent primary malignant brain tumor in adults, glioblastoma is linked to poor overall survival, high recurrence rates, and quick progression. Glioblastoma's intricate pathophysiology includes aberrant cellular proliferation, angiogenesis, neuroinflammation, genetic abnormalities, and disruption of the blood–brain barrier, all of which support the growth of the tumor and its resistance to treatment. These pathological characteristics make illness management more difficult and severely restrict the efficacy of current therapeutic approaches. Temozolomide-based chemotherapy, corticosteroids, antiepileptic medications, targeted therapies, and novel immunotherapeutic agents are examples of current pharmacotherapeutic strategies. However, inadequate medication penetration into the central nervous system, tumor heterogeneity, chemoresistance, adverse drug responses, and drug-drug interactions related to multimodal therapy continue to result in unsatisfactory treatment outcomes. Through pharmacological therapy management, therapeutic drug monitoring, adverse drug response monitoring, drug interaction discovery, patient counseling, and supportive care interventions, clinical pharmacists contribute significantly to the optimization of glioblastoma management. Their involvement can enhance neuro-oncology patients' overall therapy results, medication safety, and treatment compliance. Furthermore, new therapeutic approaches like immunotherapy, precision medicine, molecular targeted therapy, and drug delivery systems based on nanotechnology may offer promise improvements in the treatment of glioblastoma. The pathophysiological processes of glioblastoma, contemporary pharmacotherapeutic strategies, and the growing involvement of clinical pharmacists in improving patient care and therapy outcomes are all highlighted in this study.