Limited advances in therapy of glioblastoma trigger re-consideration of research policy

• Pre-clinical acquisitions on glioblastoma are not translated to patients’ benefit.
• To improve this, the following three possible measures are suggested.
• Adopting multiple-step phase II clinical trials.
• Monitoring standards of care for glioblastoma patients in European Cancer Units.
• Introducing the TIF and t index bibliometric parameters.

Glioblastoma (GB – WHO grade IV) is the most frequent and lethal primary brain tumour with median overall survival of 7–15 months after diagnosis. As in other cancer research areas, an overwhelming amount of pre-clinical research acquisitions in the GB field have not been translated to patients' benefit, potentially due to inappropriate treatment schedules and/or trial designs in the clinical setting. The recent failure of promising anti-VEGF bevacizumab to improve GB patients' overall survival recapitulates this sense of frustration. The following measures are proposed:1.to change Phase II design. Bevacizumab and other drugs may have failed in Phase III just because of an inappropriate clinical treatment schedule adopted. Multiple-step Phase II clinical trials allowing more thorough definition of treatment protocols to be extensively studied in Phase III should be designed.2.to monitor standards of care by documenting survival rates of GB patients in European Cancer Units, in order to homogenize GB treatment quality to the highest possible level all over EU28.3.to introduce the therapeutic impact factor (TIF) and therapeutic (t) index bibliometric parameters, in order to orientate pre-clinical research toward more therapy-focussed activities.