Glioblastoma-GBM IDH-Wildtype Grade 4: Patient Stable with ECCT Therapy

Daniel, Romania, Age: 60, Glioblastoma - GBM IDH-wild type, Grade 4

Daniel's story began with one of the more aggressive forms of primary brain cancer when he was first diagnosed in November 2024: IDH-wild type, Grade 4 glioblastoma. His biopsy shows:

Marker	Result	Interpretation
ATRX	Nuclear expression retained	No loss of ATRX expression detected. ATRX loss is often seen in astrocytomas, so retained ATRX does not support an ATRX-mutant pattern.
GFAP	Positive	Supports glial/astrocytic differentiation.
p53	40%	Relatively high expression and can support an abnormal TP53 pathway, although percentage alone cannot prove a TP53 mutation.
Ki-67 (MIB-1)	40%	Very high proliferative activity, suggesting a highly proliferative tumor.
Olig-2	Positive	Supports diffuse glioma / glial lineage.
IDH-1	Negative	No IDH1 R132H mutation detected by this immunostain. However, this does not completely exclude an IDH mutation, because uncommon IDH mutations may require sequencing.

The combination of GFAP positive + Olig-2 positive + IDH1 negative + Ki-67 40% is compatible with a high-grade diffuse glioma, and the Ki-67 of 40% is particularly concerning for aggressive/highly proliferative biology.

He underwent surgery in December 2024. This was followed by concurrent radiotherapy and temozolomide. Despite treatment, the disease continue to show active and aggressive.

On 17 March 2025, ECCT was added while oral temozolomide continued. Post ECCT, the presentation tracks his MRI journey from the period before ECCT through April, July and November 2025, and then again in March and June 2026 and his progress can be describes as regression followed by stability. At the latest assessments, the notes state that there was no evidence of progression and that his general condition was good and stable.

Along his journey, there were no ECCT-related complications were recorded in the case summary, and his overall condition was described as good by his oncology.

Names and identifying details have been covered to protect patient privacy. This case describes an individual’s documented journey and is provided for educational and informational purposes only. It does not constitute medical advice and should not be used as a substitute for professional medical consultation, diagnosis, or standard-of-care treatment. Individual outcomes may vary, and this case should not be interpreted as a guarantee or indication that any particular outcome, response, improvement, or result will occur in another individual.