Temozolomide resistance management

Glioblastoma (GEM) is a highly malignant primary brain tumor with high mortality. Although current standard treatments include surgery, radiation therapy, and temozolomide, chemotherapy can prolong patient survival after surgery, but most cases eventually become resistant to temozolomide. O6-methylguanine-DNA methyltransferase (MGMT) repairs major cytotoxic damage, as O6-methylguanine generated by temozolomide may be the primary mechanism of drug resistance.

Temozolomide treatment can induce self-protective autophagy, which is a mechanism by which tumor cells resist temozolomide treatment. Emerging evidence also suggests that a small subset of cells expressing stem cell markers, also known as GBM stem cells (GSCs), contribute to drug resistance and tumor recurrence due to their ability to self-renew and invade neighboring tissues. Treatments targeting these molecules and pathways lead to the suppression of GSCs and, in the case of high levels of drug resistance, a decrease in MGMT activity. Recently, some new therapeutic strategies, targeted molecules, immunotherapies, and microRNAs have provided new potential treatments for highly drug-resistant GBM cases. However, everyone’s physique is different and their resistance to drugs is also different. If drug resistance occurs after using the drug, please inform your doctor in time and do not adjust the drug dosage yourself.

The original drug temozolomide has been launched in China and has entered the scope of Class B medical insurance. Common specificationsThe price of 100mg*1 tablet*5 bags per box may be around 2,000 yuan. The price of generic temozolomide drugs marketed overseas is relatively low, and its pharmaceutical ingredients are basically the same as those of the original temozolomide drug. For example, the price of a box of 100mg*5 produced by a Bangladeshi pharmaceutical factory may be around a few hundred yuan (the price may fluctuate due to exchange rates).