skip to main content

Glioblastoma Standard Treatment — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMedical OncologyGlioblastoma Standard TreatmentRACP Adult Medicine

A 45-year-old man with new-onset seizures has an MRI showing a ring-enhancing lesion in the right parietal lobe with surrounding vasogenic oedema. He is HIV-negative and immunocompetent. Stereotactic biopsy shows a high-grade glioma (glioblastoma – IDH wild-type). What is the standard first-line treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Temozolomide alone

Standard first-line treatment for newly diagnosed glioblastoma (GBM) is maximum safe surgical resection followed by the Stupp protocol: concurrent temozolomide (75 mg/m² daily) with radiation therapy (60 Gy in 30 fractions over 6 weeks), then adjuvant temozolomide (150–200 mg/m² for 5 days every 28 days for 6 cycles). MGMT methylation status is the most important predictive biomarker for temozolomide response. For patients >70 years or with poor performance status, abbreviated regimens (hypofractionated radiation ± temozolomide) are used. Tumour treating fields (TTFields) may be added based on the EF-14 trial.

Reference: eTG – 2025 – Neurology; NCCN – 2025 – CNS Cancers