Focus on current and emerging treatment options for glioma: A comprehensive review

Brandon Lucke-Wold1, Burhanuddin Sohail Rangwala2, Muhammad Ashir Shafique3

  • 1Department of Neurosurgery, University of Florida, Gainesville, FL 32608, United States.

Insights

This review covers updates and challenges in low-grade glioma (LGG) management, focusing on promising immunotherapies like Zotiraciclib and Lerapolturev. Advancements in radiation, surgery, and personalized therapies are essential for improving patient outcomes.

Area of Science:

  • Neuro-oncology
  • Central Nervous System (CNS) Tumors
  • Cancer Immunotherapy

Background:

  • Low-grade gliomas (LGG) are common primary CNS tumors with a global incidence of 5.81 per 100,000.
  • Effective management strategies are crucial for reducing mortality and morbidity associated with these tumors.
  • The current treatment landscape necessitates continuous advancements in therapeutic techniques.

Purpose of the Study:

  • To provide a comprehensive review of current updates and challenges in LGG management.
  • To highlight the role and potential of immunotherapies in treating LGG.
  • To discuss advancements in radiation therapy, surgical techniques, and personalized medicine for LGG.

Main Methods:

  • Literature review focusing on recent studies and clinical trials related to LGG treatment.
  • Analysis of emerging immunotherapeutic agents, including small molecules and viral therapies.
  • Evaluation of surgical and radiation therapy approaches, including proton therapy.
  • Exploration of challenges in immunotherapy response and resistance mechanisms.

Main Results:

  • Immunotherapies like Zotiraciclib (CDK9 inhibitor) and Lerapolturev (viral immunotherapy) show promise in preclinical and clinical studies.
  • Pembrolizumab, Nivolumab, and Entrectinib exhibit variable patient responses, underscoring the need to understand resistance.
  • Radiation therapy, particularly proton therapy, offers improved quality of life for pediatric LGG patients.
  • Surgical extent of resection significantly impacts survival outcomes, balancing quality of life and tumor removal.

Conclusions:

  • The treatment of LGG is evolving towards personalized and targeted therapies.
  • Further research into immunotherapy resistance mechanisms and novel therapeutic combinations is essential.
  • Optimizing surgical and radiation techniques, alongside advancements in cancer vaccines, will enhance LGG management and patient outcomes.