Overview on current treatment standards in high-grade gliomas

Area of Science:

• Neuro-oncology
• Molecular Biology
• Cancer Therapeutics

Background:

• High-grade gliomas (HGGs), including anaplastic gliomas (grade III) and glioblastomas (GBM, grade IV), are primary central nervous system tumors.
• Molecular markers like IDH 1-2 mutations, 1p/19q codeletion, and MGMT methylation status are crucial for glioma subtyping and outcome prediction.

Purpose of the Study:

• To review major updates in HGG molecular biology based on the 2016 WHO Classification.
• To summarize current management strategies for newly-diagnosed and recurrent GBM and grade III gliomas.
• To present results from key clinical trials on targeted agents and immunotherapies for HGGs.

Main Methods:

• Literature review of the 2016 WHO Classification for HGGs.
• Analysis of current standard-of-care (SOC) treatments including surgery, radiotherapy, and chemotherapy.
• Evaluation of clinical trial data for targeted therapies (e.g., EGFR inhibitors) and immunotherapies (e.g., ICIs, vaccines).

Main Results:

• Standard treatments for HGGs often lead to tumor recurrence.
• Clinical trials exploring antiangiogenic agents, EGFR-targeted therapies, and various immunotherapeutic approaches have shown unsatisfactory disease control.
• Despite advances, novel therapeutic strategies are needed to improve outcomes for HGG patients.

Conclusions:

• Molecular characterization is essential for classifying HGGs and guiding treatment.
• Current therapeutic approaches for HGGs, including standard-of-care and novel agents, have limitations in controlling disease progression.
• Further research into targeted agents and immunotherapy is critical for developing more effective HGG treatments.