If you or a loved one has glioblastoma, you'll almost certainly hear the term "Stupp protocol." It's the standard, evidence-based treatment regimen that has defined glioblastoma care for about two decades, named after the lead researcher of the landmark trial that established it.
What it involves The Stupp protocol is a sequence of three phases:
- Maximal safe surgery. Remove as much tumor as can be safely removed, and obtain tissue for diagnosis.
- Concurrent chemoradiation. Radiation therapy (typically about six weeks) given together with a daily low dose of temozolomide chemotherapy.
- Adjuvant temozolomide. After a short break, higher-dose temozolomide taken for several days in monthly cycles, commonly for about six cycles.
Why it matters When this regimen was established, it was a genuine breakthrough — adding temozolomide to radiation increased median survival compared with radiation alone and, importantly, improved the proportion of patients surviving longer-term. It remains the foundation of first-line glioblastoma treatment today.
What's often added Many patients also use Tumor Treating Fields (a wearable device) during the maintenance phase, which has been shown to further extend survival when added to temozolomide. MGMT methylation status helps predict how much benefit temozolomide is likely to provide. And clinical trials are frequently worth exploring, often built around or alongside the Stupp backbone.
An honest note on expectations The Stupp protocol meaningfully extends survival and is the right standard of care, but glioblastoma remains very challenging, and the regimen is not a cure. Median survival with standard treatment is often cited around 14–15 months, though individual outcomes vary with age, extent of surgery, MGMT status, overall health, and access to trials. Active research continues to build on this foundation.
If glioblastoma is your diagnosis, ask your team how the Stupp protocol applies to you, whether Tumor Treating Fields are recommended, what your MGMT status is, and what trials might be available. Understanding the standard helps you make sense of everything your team proposes.