Fueyo Juan, Gomez-Manzano Candelaria, Yung W K Alfred
Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Arch Neurol. 2011 Mar;68(3):303-8. doi: 10.1001/archneurol.2010.293. Epub 2010 Nov 8.
During the last decade, we have witnessed several key advances in the field of neuro-oncology. First, there were conceptual advances in the molecular and cell biology of malignant gliomas including the discovery in 2004 of brain tumor stem cells. Second, the Cancer Genome Atlas project has been extremely useful in the discovery of new molecular markers, including mutations in the IDH1 gene, and has led to a new classification of gliomas based on the differentiation status and mesenchymal transformation. In addition, use of the 1p/19q marker and O6-methylguanine-DNA methyltransferase methylation status have been identified as guides for patient selection for therapies and represent the first steps toward personalized medicine for treating gliomas. Finally, progress has been made in treatment strategies including the establishment of temozolomide as the criterion standard for treating gliomas, the adoption of bevacizumab in the clinical setting, and developments in experimental biological therapies including cancer vaccines and oncolytic adenoviruses.
在过去十年中,我们见证了神经肿瘤学领域的几项关键进展。首先,恶性胶质瘤的分子和细胞生物学取得了概念上的进展,包括2004年发现脑肿瘤干细胞。其次,癌症基因组图谱计划在发现新的分子标志物方面极为有用,包括异柠檬酸脱氢酶1(IDH1)基因突变,并导致了基于分化状态和间充质转化的胶质瘤新分类。此外,1p/19q标志物的使用和O6-甲基鸟嘌呤-DNA甲基转移酶甲基化状态已被确定为治疗患者选择的指导原则,并代表了胶质瘤个性化治疗的第一步。最后,治疗策略也取得了进展,包括确立替莫唑胺作为治疗胶质瘤的标准方案、在临床环境中采用贝伐单抗,以及实验性生物治疗的进展,包括癌症疫苗和溶瘤腺病毒。