Department of Neurology, Faculty Hospital in Pilsen, Alej svobody 80, 304 60 Pilsen, Czech Republic.
Anticancer Res. 2012 Jul;32(7):2935-46.
Glioblastoma multiforme (GBM) is the most malignant brain tumor in adults, exhibiting high mortality. Standard therapy (surgery, radiotherapy and chemotherapy with temozolomide) has only limited effectiveness. The progress in genomics regarding GBM, in the detection of new markers of oncogenesis, abnormalities in signalling pathways, tumor microenvironment, and pathological angiogenesis over the past decade are briefly discussed. The role of novel prognostic in this review biomarkers [isocitrate dehydrogenases 1 and 2, CpG island methylator phenotype, promoter methylation status of the MGMT (O-6-methylguanine-methyltransferase) gene] is also discussed. New targeted therapeutic approaches are classified into several functional subgroups, such as inhibitors of growth factors and their receptors, inhibitors of proteins of intracellular signaling pathways, epigenetic gene-expressing mechanisms, inhibitors of tumor angiogenesis, tumor imunotherapy and vaccines. Finally novel possibilities for GBM treatment are summarized in this review.
多形性胶质母细胞瘤(GBM)是成人中最恶性的脑肿瘤,死亡率很高。标准疗法(手术、放疗和替莫唑胺化疗)的效果有限。简要讨论了过去十年中关于 GBM 的基因组学进展,包括新的致癌标志物、信号通路异常、肿瘤微环境和病理性血管生成的检测。本综述还讨论了新型预后生物标志物(异柠檬酸脱氢酶 1 和 2、CpG 岛甲基化表型、MGMT(O-6-甲基鸟嘌呤甲基转移酶)基因启动子甲基化状态)的作用。新的靶向治疗方法分为几个功能亚组,如生长因子及其受体抑制剂、细胞内信号通路蛋白抑制剂、表观遗传基因表达机制抑制剂、肿瘤血管生成抑制剂、肿瘤免疫治疗和疫苗。最后,本文综述了 GBM 治疗的新可能性。
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