Le Rhun Emilie, Taillibert Sophie, Chamberlain Marc C
Department of Neuro-oncology, Roger Salengro Hospital, University Hospital, Lille, France.
Expert Rev Neurother. 2015 Jun;15(6):601-20. doi: 10.1586/14737175.2015.1042455. Epub 2015 May 2.
Anaplastic glioma (AG) is divided into three morphology-based groups (anaplastic astrocytoma, anaplastic oligodendroglioma, anaplastic oligoastrocytoma) as well as three molecular groups (glioma-CpG island methylation phenotype [G-CIMP] negative, G-CIMP positive non-1p19q codeleted tumors and G-CIMP positive codeleted tumors). The RTOG 9402 and EORTC 26951 trials established radiotherapy plus (procarbazine, lomustine, vincristine) chemotherapy as the standard of care in 1p/19q codeleted AG. Uni- or non-codeleted AG are currently best treated with radiotherapy only or alkylator-based chemotherapy only as determined by the NOA-04 trial. Maturation of NOA-04 and results of the currently accruing studies, CODEL (for codeleted AG) and CATNON (for uni or non-codeleted AG), will likely refine current up-front treatment recommendations for AG.
间变性胶质瘤(AG)分为三个基于形态学的组(间变性星形细胞瘤、间变性少突胶质细胞瘤、间变性少突星形细胞瘤)以及三个分子组(胶质瘤CpG岛甲基化表型[G-CIMP]阴性、G-CIMP阳性非1p19q共缺失肿瘤和G-CIMP阳性共缺失肿瘤)。RTOG 9402和EORTC 26951试验确立了放疗联合(丙卡巴肼、洛莫司汀、长春新碱)化疗作为1p/19q共缺失AG的标准治疗方案。根据NOA-04试验,单共缺失或非共缺失AG目前最佳的治疗方法是仅进行放疗或仅进行基于烷化剂的化疗。NOA-04的成熟以及目前正在进行的研究CODEL(针对共缺失AG)和CATNON(针对单共缺失或非共缺失AG)的结果可能会完善目前针对AG的初始治疗建议。