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Ibudilast (MN-166) is a small molecule anti-inflammatory drug that inhibits macrophage migration inhibitory factor (MIF), which is overexpressed in glioblastoma and associated with poor survival. Temozolomide (TMZ) is an alkylating agent used as first-line chemotherapy for glioblastoma. The combination of ibudilast and temozolomide has shown preclinical synergy in inhibiting cell proliferation, reducing MIF protein levels, inducing cell cycle arrest at G2 phase, increasing apoptosis in patient-derived glioblastoma cell lines regardless of MGMT methylation status, and significantly prolonging survival in patient-derived xenograft models[2][4][7]. Clinical trials have evaluated this combination for safety, tolerability, and efficacy in newly diagnosed or recurrent glioblastoma[1][3][6].
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