Sardi Iacopo, Cavalieri Duccio, Massimino Maura
Department of Pediatrics, Onco-hematology and Neuro-surgery Units, University of Florence Medical School, A. Meyer Children's Hospital, Florence, Italy.
Paediatr Drugs. 2007;9(2):81-96. doi: 10.2165/00148581-200709020-00002.
The past decades have seen an increase in the survival rates of patients with standard-risk medulloblastoma. Efforts have, therefore, been focused on obtaining better results in the treatment of patients with high-risk tumors. In addition to consolidated therapies, novel approaches such as small molecules, monoclonal antibodies, and antiangiogenic therapies that aim to improve outcomes and quality of life are now available through new breakthroughs in the molecular biology of medulloblastoma. The advent of innovative anticancer drugs tested in brain tumors has important consequences for personalized therapy. Gene expression profiling of medulloblastoma can be used to identify the genes and signaling transduction pathways that are crucial for the tumorigenesis process, thereby revealing both new targets for therapy and sensitive/resistance phenotypes. The interpretation of microarray data for new treatments of patients with high-risk medulloblastoma, as well as other poor prognosis tumors, should be developed through a consensus multidisciplinary approach involving oncologists, neurosurgeons, radiotherapists, biotechnologists, bioinformaticists, and other professionals.
在过去几十年中,标准风险髓母细胞瘤患者的生存率有所提高。因此,人们的努力集中在提高高危肿瘤患者的治疗效果上。除了巩固治疗外,小分子、单克隆抗体和抗血管生成治疗等旨在改善预后和生活质量的新方法,如今通过髓母细胞瘤分子生物学的新突破得以应用。在脑肿瘤中测试的创新抗癌药物的出现,对个性化治疗具有重要意义。髓母细胞瘤的基因表达谱可用于识别对肿瘤发生过程至关重要的基因和信号转导通路,从而揭示新的治疗靶点以及敏感/耐药表型。对于高危髓母细胞瘤患者以及其他预后不良肿瘤的新治疗方法,微阵列数据的解读应通过肿瘤学家、神经外科医生、放射治疗师、生物技术专家、生物信息学家和其他专业人员参与的多学科共识方法来开展。