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High-grade Gliomas.

Lakshmi Nayak, David A Reardon

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    Standard high-grade glioma treatments like surgery, radiation, and chemotherapy are improving with new molecular insights and therapies. While outcomes remain challenging, novel strategies offer promising advancements for brain tumor patients.

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    Area of Science:

    • Neuro-oncology
    • Cancer therapy
    • Molecular diagnostics

    Background:

    • High-grade gliomas (HGGS) are aggressive brain tumors with limited treatment options.
    • Recent advancements in molecular classification are crucial for understanding HGGS.
    • Despite aggressive multimodal treatment, patient outcomes remain poor.

    Purpose of the Study:

    • To review current standard treatments for high-grade gliomas.
    • To explore emerging therapeutic strategies and response assessment methods.
    • To highlight the impact of molecular markers on glioma classification and treatment.

    Main Methods:

    • Review of current literature on high-grade glioma treatment.
    • Analysis of recent clinical trial data and FDA approvals.
    • Discussion of novel therapeutic approaches including targeted agents and immunotherapies.

    Main Results:

    • The World Health Organization (WHO) classification now incorporates molecular markers for HGGS.
    • Chemotherapy (procarbazine, lomustine, vincristine) combined with radiation significantly improved survival in 1p/19q-codeleted anaplastic oligodendrogliomas.
    • Tumor treating fields combined with temozolomide are FDA-approved for newly diagnosed glioblastoma.

    Conclusions:

    • Surgery, radiation, and chemotherapy are the established treatments for HGGS.
    • Outcomes for HGGS have seen minimal improvement over the last decade.
    • Advances in understanding HGGS biology are paving the way for more effective, novel therapies.