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Glioma Subclassifications and Their Clinical Significance | Neurotherapeutics
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The impact of targeted therapies in glioma has been modest. All the therapies that have demonstrated a significant survival benefit for gliomas in Phase III trials, including radiation, chemotherapy (temozolomide and PCV [procarbazine, lomustine, vincristine]), and tumor-treating fields, are based on nonspecific targeting of proliferating cells. Recent advances in the molecular understanding of gliomas suggest some potential reasons for the failure of more targeted therapies in gliomas. Specifically, the histologic-based glioma classification is composed of multiple different molecular subtypes with distinct biology, natural history, and prognosis. As a result of these insights, the diagnosis and classification of gliomas have recently been updated by the World Health Organization. However, these changes and other novel observations regarding glioma biomarkers and subtypes highlight several clinical challenges. First, the field is faced with the difficulty of reinterpreting the results of prior studies and retrospective data using the new classifications to clarify prognostic assessments and treatment recommendations for patients. Second, the new classifications and insights require rethinking the design and stratification of future clinical trials. Last, these observations provide the essential framework for the development and testing of new specific targeted therapies for particular glioma subtypes. This review aims to summarize the current literature regarding glioma subclassifications and their clinical relevance in this evolving field.
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Keywords {๐}
pubmed, google, scholar, gliomas, tumors, idh, mutations, cas, molecular, central, mutation, glioma, classification, survival, cancer, clinical, gbm, patients, subtypes, mgmt, grade, braf, tumor, methylation, glioblastoma, prognosis, cell, gbms, oncol, cells, promoter, iii, based, diagnosis, ependymomas, alterations, prognostic, therapy, tert, analysis, therapies, temozolomide, studies, treatment, gene, trials, years, identified, genetic, group,
Topics {โ๏ธ}
nuclear factor ฮบ-light-chain-enhancer canonical nf-ฮบb signalling veliparib-mediated temozolomide-sensitizing therapy chimeric antigen receptor causing double-strand breaks high-affinity monoclonal antibody hypoxia-related proline hydroxylases raf-erk signaling pathway egfr-targeting therapies include gov/ct2/show/nct02573324 braf v600e-targeted therapy serine/threonine protein kinase cpg-rich region results idh wild-type counterparts central nervous system o6-methylguanine adducts induced tert wild-type tumor 1p/19q status โinformallyโ pediatric high-grade glioma tumor necrosis factor-ฮฑ o6-methylguanine-dna methyltransferase extra-cerebellar pilocytic astrocytoma anti-egfrviii vaccine c11orf95โrela fusions resulted validated 1p/19q deletion idh wild-type gliomas endogenous t-cell responses matthew smith-cohn anaplastic-level diffuse gliomas pediatric low-grade gliomas diffuse lower-grade gliomas idh wild-type gbm intact chromosome 1p/19q gene methylation-based subtyping idh1/idh2 wild-type adult low-grade gliomas separate amino-acid substitution concomitant low-grade astrocytoma mixed neuronal-glial tumors nf-ฮบb pathways receptor tyrosine kinase idh wild-type lggs braf inhibitor therapy chromosome 1p/19q deletion 1p/19q-intact tumors [27] world health organization chromosome 1p/19q loss egfr-targeted therapy dna-repair gene mgmt progression-free survival ranging
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- Epithelioid glioblastomas and anaplastic epithelioid pleomorphic xanthoastrocytomas-same entity or first cousins?
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mainEntity:
headline:Glioma Subclassifications and Their Clinical Significance
description:The impact of targeted therapies in glioma has been modest. All the therapies that have demonstrated a significant survival benefit for gliomas in Phase III trials, including radiation, chemotherapy (temozolomide and PCV [procarbazine, lomustine, vincristine]), and tumor-treating fields, are based on nonspecific targeting of proliferating cells. Recent advances in the molecular understanding of gliomas suggest some potential reasons for the failure of more targeted therapies in gliomas. Specifically, the histologic-based glioma classification is composed of multiple different molecular subtypes with distinct biology, natural history, and prognosis. As a result of these insights, the diagnosis and classification of gliomas have recently been updated by the World Health Organization. However, these changes and other novel observations regarding glioma biomarkers and subtypes highlight several clinical challenges. First, the field is faced with the difficulty of reinterpreting the results of prior studies and retrospective data using the new classifications to clarify prognostic assessments and treatment recommendations for patients. Second, the new classifications and insights require rethinking the design and stratification of future clinical trials. Last, these observations provide the essential framework for the development and testing of new specific targeted therapies for particular glioma subtypes. This review aims to summarize the current literature regarding glioma subclassifications and their clinical relevance in this evolving field.
datePublished:2017-03-09T00:00:00Z
dateModified:2017-03-09T00:00:00Z
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Ependymoma
Targeted therapy
IDH mutation
MGMT methylation
TERT promoter
EGFR
BRAF
1p/19q co-deletion
2HG
MR spectroscopy
Vaccine therapy
Neurosciences
Neurology
Neurosurgery
Neurobiology
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headline:Glioma Subclassifications and Their Clinical Significance
description:The impact of targeted therapies in glioma has been modest. All the therapies that have demonstrated a significant survival benefit for gliomas in Phase III trials, including radiation, chemotherapy (temozolomide and PCV [procarbazine, lomustine, vincristine]), and tumor-treating fields, are based on nonspecific targeting of proliferating cells. Recent advances in the molecular understanding of gliomas suggest some potential reasons for the failure of more targeted therapies in gliomas. Specifically, the histologic-based glioma classification is composed of multiple different molecular subtypes with distinct biology, natural history, and prognosis. As a result of these insights, the diagnosis and classification of gliomas have recently been updated by the World Health Organization. However, these changes and other novel observations regarding glioma biomarkers and subtypes highlight several clinical challenges. First, the field is faced with the difficulty of reinterpreting the results of prior studies and retrospective data using the new classifications to clarify prognostic assessments and treatment recommendations for patients. Second, the new classifications and insights require rethinking the design and stratification of future clinical trials. Last, these observations provide the essential framework for the development and testing of new specific targeted therapies for particular glioma subtypes. This review aims to summarize the current literature regarding glioma subclassifications and their clinical relevance in this evolving field.
datePublished:2017-03-09T00:00:00Z
dateModified:2017-03-09T00:00:00Z
pageStart:284
pageEnd:297
sameAs:https://doi.org/10.1007/s13311-017-0519-x
keywords:
Glioma
Ependymoma
Targeted therapy
IDH mutation
MGMT methylation
TERT promoter
EGFR
BRAF
1p/19q co-deletion
2HG
MR spectroscopy
Vaccine therapy
Neurosciences
Neurology
Neurosurgery
Neurobiology
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