Case Report WIN-MTB-2024001 - WIN International Molecular Tumor Board: A 55-year-old male with glioblastoma exhibiting amplifications in MDM2 and EGFR

Wafik S. El-Deiry1,2,*, Sadakatsu Ikeda3, Shai Magidi1, Catherine Bresson1, Hikmat Abdel-Razeq5, Anthony Joshua6, Alberto Hernando-Calvo7, Arjun Oberoi7, Zhihuang Hu4, Tobias Meissner8, Rachel Elsey8, Amal Al-Omari5, Fanny Wunder1 and Razelle Kurzrock1,9,* 1 Worldwide Innovative Network (WIN) Association - WIN Consortium, Chevilly-Larue 94550, France 2 Legorreta Cancer Center at Brown University, Providence, RI 02912, USA 3 Institute of Science Tokyo Hospital, Tokyo 113-8510, Japan 4 Fudan University Shanghai Cancer Center, Shanghai 200032, China 5 King Hussein Cancer Center, Amman 11941, Jordan 6 The Kinghorn Cancer Centre, St Vincent's Hospital, Darlinghurst, NSW 2010, Australia 7 Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Barcelona 08035, Spain 8 Avera Cancer Institute, Sioux Falls, SD 57105, USA 9 Medical College of Wisconsin, Milwaukee, WI 53226, USA * These authors contributed equally to this work Correspondence to: Wafik S. El-Deiry, email:[email protected] Keywords: cancer; precision oncology; molecular tumor board; glioblastoma Received: April 15, 2026 Accepted: September 03, 2026 Published: October 16, 2026 Copyright: © 2026 El-Deiry et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ABSTRACT The WIN Consortium International Molecular Tumor Board brings together precision oncology experts from 18 organizations in 13 countries across four continents and provides discussion for patients with cancer across the world. This case report details the medical journey of a 55-year-old man diagnosed with high-grade glioblastoma (GBM), characterized by amplifications of MDM2 and EGFR, alongside other critical genomic alterations, including a CDKN2A frameshift mutation. Despite the aggressive nature of GBM, the patient was in remission following a combination of radiotherapy and chemotherapy, surgery and participation in a phase II clinical trial (PI3K/mTOR inhibitor) combined with ketogenic diet and metformin. However, the patient was also considering personalized neoantigen vaccine therapy targeting tumor-specific mutated peptides as part of his treatment strategy. This case underscores the immense complexity of treating GBM. Next generation sequencing showed MDM2 amplification, which hinders the tumor-suppressive functions of p53, and EGFR amplification, which promotes oncogenic signaling. The experts highlighted various therapeutic options discussed in the event of relapse: EGFR inhibitors, various MDM2 inhibitors, and personalized combination therapies targeting both EGFR and CDK4/6. Additionally, the Molecular Tumor Board discussed the reported risk of resistance or hyper-progression with immune checkpoint blockade in the presence of EGFR and MDM2 alterations. Innovative approaches such as combining MDM2 and EGFR inhibitors with immunotherapy, as well as the use of teserpaturev, a genetically engineered herpes simplex virus were addressed. This case emphasizes the importance of personalized treatment strategies for GBM and the need for ongoing clinical research to explore novel therapeutic options.