Auffinger Brenda, Thaci Bart, Nigam Pragati, Rincon Esther, Cheng Yu, Lesniak Maciej S
The Brain Tumor Center, The University of Chicago Pritzker School of Medicine 5841 South Maryland Ave, M/C 3026, Chicago, IL 60637.
F1000 Med Rep. 2012;4:18. doi: 10.3410/M4-18. Epub 2012 Sep 5.
Malignant gliomas are heterogeneous, diffuse and highly infiltrating by nature. Despite wide surgical resection and improvements in radio- and chemotherapies, the prognosis of patients with glioblastoma multiforme remains extremely poor, with a median survival time of only 14.5 months from diagnosis to death. Particular challenges for glioblastoma multiforme therapy are posed by limitations in the extent of feasible surgical resections, distinct tumor heterogeneity, difficulties in drug delivery across the blood-brain barrier and low drug distribution within the tumor. Therefore, new paradigms permitting tumor-specific targeting and extensive intratumoral distribution must be developed to allow an efficient therapeutic delivery. This review highlights the latest advances in the treatment of glioblastoma multiforme and the recent developments that have resulted from the interchange between preclinical and clinical efforts. We also summarize and discuss novel therapies for malignant glioma, focusing on advances in the following main topics of glioblastoma multiforme therapy: immunotherapy, gene therapy, stem cell-based therapies and nanotechnology. We discuss strategies and outcomes of emerging therapeutic approaches in these fields, and the main challenges associated with the integration of discoveries that occur in the laboratory into clinical practice.
恶性胶质瘤本质上具有异质性、弥漫性且高度浸润性。尽管进行了广泛的手术切除以及放疗和化疗有所改进,但多形性胶质母细胞瘤患者的预后仍然极差,从诊断到死亡的中位生存时间仅为14.5个月。多形性胶质母细胞瘤治疗面临的特殊挑战包括可行手术切除范围的限制、明显的肿瘤异质性、跨越血脑屏障进行药物递送的困难以及肿瘤内药物分布较低。因此,必须开发允许肿瘤特异性靶向和广泛肿瘤内分布的新范式,以实现有效的治疗递送。本综述重点介绍了多形性胶质母细胞瘤治疗的最新进展以及临床前和临床研究相互交流所带来的最新发展。我们还总结并讨论了恶性胶质瘤的新型疗法,重点关注多形性胶质母细胞瘤治疗以下主要主题的进展:免疫疗法、基因疗法、基于干细胞的疗法和纳米技术。我们讨论了这些领域新兴治疗方法的策略和结果,以及将实验室发现整合到临床实践中所面临的主要挑战。
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