Center for Neuro-Oncology, Department of Medical Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA 02115, USA.
J Neurooncol. 2010 Sep;99(3):365-78. doi: 10.1007/s11060-010-0349-8. Epub 2010 Sep 4.
Meningiomas are the most common primary brain tumor in adults. Although the majority of these tumors can be effectively treated with surgery and radiation therapy, an important subset of patients have inoperable tumors, or develop recurrent disease after surgery and radiotherapy, and require some form of medical therapy. There are increasing numbers of studies evaluating various medical therapies but the results remain disappointing. Chemotherapies and hormonal therapies have been generally ineffective, although somatostatin analogues may have therapeutic potential. There is also increasing interest in targeted molecular therapies. Agents inhibiting platelet derived growth factor receptors and epidermal growth factor receptors have shown little efficacy, but molecular agents inhibiting vascular endothelial growth factor receptors appear to have some promise. As with other tumors, advances in the medical therapies for meningiomas will require improved understanding of the molecular pathogenesis of these tumors, more predictive preclinical models, and efficient mechanisms for conducting clinical trials, given the small population of eligible patients.
脑膜瘤是成年人中最常见的原发性脑肿瘤。尽管大多数此类肿瘤可以通过手术和放射疗法有效治疗，但仍有一部分患者肿瘤无法手术切除，或在手术后和放射治疗后复发，需要某种形式的药物治疗。目前有越来越多的研究评估各种药物治疗方法，但结果仍令人失望。化疗和激素治疗通常无效，尽管生长抑素类似物可能具有治疗潜力。靶向分子治疗也越来越受到关注。抑制血小板衍生生长因子受体和表皮生长因子受体的药物疗效甚微，但抑制血管内皮生长因子受体的分子药物似乎有一定的前景。与其他肿瘤一样，脑膜瘤的药物治疗进展需要更好地了解这些肿瘤的分子发病机制，建立更具预测性的临床前模型，以及建立有效的临床试验机制，因为符合条件的患者人数较少。
