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Case study: 59-year old female with history of GBM

History of present illness: A 59-year-old female presents for routine follow-up, noting nose bleeds, fatigue, chronic headaches, and dry skin. She was diagnosed with glioblastoma multiforme 14 months earlier that relapsed after 8 months, and given a prognosis of 6-12 months to live. She has chemotherapy before joining the ReACT trial where she was given bevacizumab with rindopepimut.

Social history: Patient denies alcohol, tobacco and ilicit drug use. She lives with her husband. She is a retired opera singer.

Medication: Bevacizumab; rindopepimut. Petroleum jelly on patches of dry/rough skin.

Allergies: None

Past medical history: Recurrent GBM 8 months after initial diagnosis, which was 14 months ago.

1. Patient describes debilitating headaches. What would you prescribe in terms of tests and/or medication?

2. How do you stay in touch with the patient's treatment team?

3. What special warning signs (if any) do you look for in this patient?