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Glioma therapy in adults
Andrew D Norden1, Patrick Y Wen
1Division of Cancer Neurology, Department of Neurology, Brigham and Women's Hospital and Center For Neuro-Oncology, Dana Farber Brigham and Women's Cancer Center, Boston, Massachusetts 02115, USA.
Background:
Gliomas are the most common type of primary brain tumor. Nearly two-thirds of gliomas are highly malignant lesions that account for a disproportionate share of brain tumor-related morbidity and mortality. Despite recent advances, two-year survival for glioblastoma with optimal therapy is less than 30%. Even among patients with low-grade gliomas that confer a relatively good prognosis, treatment is almost never curative.
Review Summary:
Surgery and radiation have been the mainstays of therapy for most glioma patients, but temozolomide chemotherapy has recently been proven to prolong overall survival in patients with glioblastoma. Intriguing data suggests that activity of O6-methylguanine-DNA methyltransferase (MGMT), in tumor cells may predict responsiveness to temozolomide and other alkylating agents. Novel treatment approaches, especially targeted molecular therapies against critical components of glioma signaling pathways, appear promising in preliminary studies. Optimal treatment for patients with low-grade gliomas has yet to be determined. Advances in oligodendroglioma biology have identified loss of chromosomes 1p and 19q as powerful indicators of a favorable prognosis. These same changes may predict response to chemotherapy.
Conclusions:
Though the prognosis for many patients with gliomas is poor, the last decade produced a number of important advances, some of which have translated directly into survival benefits. Rapid progress in the field of glioma molecular biology continues to identify therapeutic targets and provide hope for the future of this challenging disease.
Insights
Recent advances in glioma treatment, including temozolomide chemotherapy and targeted molecular therapies, offer improved survival for brain tumor patients. Further research into glioma molecular biology continues to identify new therapeutic targets.
Area of Science:
- Neuro-oncology
- Cancer Biology
- Molecular Therapeutics
Background:
- Gliomas represent the most common primary brain tumors, with high-grade malignancies causing significant morbidity and mortality.
- Glioblastoma survival rates remain low, and curative treatments for low-grade gliomas are lacking.
- Current treatments offer limited long-term benefits for many glioma patients.
Purpose of the Study:
- To review recent advances in glioma diagnosis and treatment.
- To highlight the role of molecular markers in predicting treatment response.
- To discuss emerging therapeutic strategies for gliomas.
Main Methods:
- Review of current surgical, radiotherapeutic, and chemotherapeutic approaches for gliomas.
- Analysis of data on temozolomide efficacy and O6-methylguanine-DNA methyltransferase (MGMT) activity.
- Exploration of novel molecular targeted therapies and their preliminary findings.
- Examination of genetic markers, such as 1p/19q loss, in oligodendroglioma prognosis and treatment response.
Main Results:
- Temozolomide chemotherapy has demonstrated improved survival for glioblastoma patients.
- O6-methylguanine-DNA methyltransferase (MGMT) activity may predict response to temozolomide and alkylating agents.
- Loss of chromosomes 1p and 19q is associated with a favorable prognosis and potential chemotherapy response in oligodendrogliomas.
- Targeted molecular therapies show promise in preliminary studies.
Conclusions:
- Significant progress in glioma molecular biology has led to therapeutic advances and improved survival.
- Ongoing research continues to identify novel therapeutic targets for challenging brain tumors.
- While prognosis remains poor for many, recent developments offer hope for improved patient outcomes.
