From:  The evolution of chemotherapy in brain tumors: from historical milestones to precision medicine in glioblastoma

 Recent preclinical studies (in vitro and/or in vivo models) exploring TMZ-based therapies in GBM.

Study titleDescriptionYearMechanism of action/pathway involvedRef.
Evaluation of temozolomide and fingolimod treatments in glioblastoma preclinical modelsPreclinical study evaluates the effects of TMZ and fingolimod (an immunomodulatory drug) in GBM 2D and 3D models.2023Fingolimod inhibits the S1P/S1PR axis, potentially enhancing TMZ efficacy via immune and TME modulation.[116]
Loco-regional treatment with temozolomide-loaded thermogels prevents glioblastoma recurrences in orthotopic human xenograft modelsThis study investigated the use of TMZ-loaded thermogels for loco-regional treatment in GBM models, aiming to improve drug delivery and therapeutic outcomes.2023The thermogels provide sustained release of TMZ at the tumor site, potentially improving its efficacy while reducing systemic toxicity.[117]
Efficacy of EGFR plus TNF inhibition in a preclinical model of temozolomide-resistant glioblastomaEvaluation of the efficacy of combined EGFR and TNF inhibition in an orthotopic murine model of GBM, compared to standard treatment with TMZ.2019Dual inhibition reduced tumor-promoting inflammation and EGFR signalling, enhancing antitumor immunity.[118]
Piperlongumine conquers temozolomide chemoradiotherapy resistance to achieve immune cure in refractory glioblastoma via boosting oxidative stress-inflamation-CD8+-T cell immunityPiperlongumine enhances chemoradiotherapy efficacy and overcomes resistance in GBM by promoting anti-tumor immunity.2023Piperlongumine restores ROS levels reduced by RT/TMZ therapy, activating oxidative stress-related genes and immune responses, while reducing tumor cell proliferation/invasion and increasing apoptosis.[119]
NEO212, temozolomide conjugated to NEO100, exerts superior therapeutic activity over temozolomide in preclinical chemoradiation models of glioblastomaThe molecule NEO212 (TMZ–NEO100 conjugate) showed stronger anticancer activity than single agents in LN229, T98G, U251, and TMZ-resistant LN229TR2 cells (in silico and in vivo).2024Enhanced DNA damage, reduced MGMT activity; in silico modelling showed enhanced drug delivery and efficacy by targeting tumor-specific pathways.[120]
The Temozolomide–Doxorubicin paradox in Glioblastoma in vitro–in silico preclinical drug-screeningCombined in vitro and in silico screening revealed a paradoxical antagonism between TMZ and doxorubicin in GBM U87MG and primary culture.2024In silico analysis demonstrates doxorubicin may reduce TMZ cytotoxicity in GBM by enhancing DNA repair and modulating cell cycle progression.[121]
Patient-derived organoids recapitulate glioma-intrinsic immune program and progenitor populations of glioblastomaPreclinical study using patient-derived GBM organoids to model tumor-intrinsic immune programs and progenitor cell populations, enabling evaluation of therapeutic responses including TMZ.2024Organoids maintain GBM heterogeneity, immune interactions, and stem/progenitor populations, providing a relevant model for testing TMZ efficacy and resistance mechanisms.[122]
Overexpression of miR-124 enhances the therapeutic benefit of TMZ treatment in the orthotopic GBM mice model by inhibition of DNA damage repairPreclinical study in vitro (GBM cell lines) and in vivo (orthotopic GBM mouse model) showing that miR-124 overexpression improves the therapeutic benefit of TMZ.2025Inhibition of DNA damage repair via suppression of RAD51, impairing homologous recombination and enhancing TMZ cytotoxicity.[123]

S1P: sphingosine-1-phosphate; S1PR: sphingosine-1-phosphate receptor; RT: radiotherapy; RAD51: molecule in DNA damage repair.