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Published on: January 19, 2019
Small molecule and monoclonal antibody therapies in neurooncology
Nicholas Butowski1, Susan M Chang
1Department of Neurological Surgery, University of California, San Francisco, CA 94143-0350, USA.
Background:
The prognosis for most patients with primary brain tumors remains poor. Recent advances in molecular and cell biology have led to a greater understanding of molecular alterations in brain tumors. These advances are being translated into new therapies that will hopefully improve the prognosis for patients with brain tumors.
Methods:
We reviewed the literature on small molecule targeted agents and monoclonal antibodies used in brain tumor research and brain tumor clinical trials for the past 20 years.
Results:
Brain tumors commonly express molecular abnormalities. These alterations can lead to the activation of cell pathways involved in cell proliferation. This knowledge has led to interest in novel anti-brain-tumor therapies targeting key components of these pathways. Many drugs and monoclonal antibodies have been developed that modulate these pathways and are in various stages of testing.
Conclusions:
The use of targeted therapies against brain tumors promises to improve the prognosis for patients with brain tumors. However, as the molecular pathogenesis of brain tumors has not been linked to a single genetic defect or target, molecular agents may need to be used in combinations or in tandem with cytotoxic agents. Further study of these agents in well-designed cooperative clinical trials is needed.
Insights
Targeted therapies show promise for improving brain tumor prognosis by targeting molecular alterations. Combinations of agents may be necessary due to complex tumor biology, requiring further clinical trials.
Area of Science:
- Neuro-oncology
- Molecular Biology
- Pharmacology
Background:
- Primary brain tumors have a poor prognosis.
- Advances in molecular biology enhance understanding of brain tumor alterations.
- New therapies are being developed to improve patient outcomes.
Purpose of the Study:
- To review small molecule targeted agents and monoclonal antibodies in brain tumor research.
- To assess their use in clinical trials over the past 20 years.
Main Methods:
- Literature review of targeted agents and monoclonal antibodies.
- Analysis of studies in brain tumor research and clinical trials.
- Focus on therapies developed over the last two decades.
Main Results:
- Brain tumors frequently exhibit molecular abnormalities driving proliferation.
- Novel therapies targeting these pathways are under development.
- Numerous drugs and antibodies modulating these pathways are in clinical trials.
Conclusions:
- Targeted therapies offer potential for improved brain tumor prognosis.
- Combination therapies may be required due to complex molecular pathogenesis.
- Further cooperative clinical trials are essential to evaluate these agents.
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