Szopa Wojciech, Burley Thomas A, Kramer-Marek Gabriela, Kaspera Wojciech
Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland.
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK.
Biomed Res Int. 2017;2017:8013575. doi: 10.1155/2017/8013575. Epub 2017 Feb 20.
Glioblastoma (GBM) is a primary neuroepithelial tumor of the central nervous system, characterized by an extremely aggressive clinical phenotype. Patients with GBM have a poor prognosis and only 3-5% of them survive for more than 5 years. The current GBM treatment standards include maximal resection followed by radiotherapy with concomitant and adjuvant therapies. Despite these aggressive therapeutic regimens, the majority of patients suffer recurrence due to molecular heterogeneity of GBM. Consequently, a number of potential diagnostic, prognostic, and predictive biomarkers have been investigated. Some of them, such as IDH mutations, 1p19q deletion, MGMT promoter methylation, and EGFRvIII amplification are frequently tested in routine clinical practice. With the development of sequencing technology, detailed characterization of GBM molecular signatures has facilitated a more personalized therapeutic approach and contributed to the development of a new generation of anti-GBM therapies such as molecular inhibitors targeting growth factor receptors, vaccines, antibody-based drug conjugates, and more recently inhibitors blocking the immune checkpoints. In this article, we review the exciting progress towards elucidating the potential of current and novel GBM biomarkers and discuss their implications for clinical practice.
胶质母细胞瘤(GBM)是一种中枢神经系统原发性神经上皮肿瘤,具有极其侵袭性的临床表型。GBM患者预后较差,只有3%至5%的患者能存活超过5年。目前GBM的治疗标准包括最大限度切除,随后进行放疗并辅以同步和辅助治疗。尽管有这些积极的治疗方案,但由于GBM的分子异质性,大多数患者会复发。因此,人们对一些潜在的诊断、预后和预测生物标志物进行了研究。其中一些,如异柠檬酸脱氢酶(IDH)突变、1p19q缺失、O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)启动子甲基化和表皮生长因子受体变体III(EGFRvIII)扩增,在常规临床实践中经常进行检测。随着测序技术的发展,对GBM分子特征的详细表征促进了更个性化的治疗方法,并推动了新一代抗GBM疗法的发展,如靶向生长因子受体的分子抑制剂、疫苗、基于抗体的药物偶联物,以及最近的免疫检查点阻断抑制剂。在本文中,我们回顾了在阐明当前和新型GBM生物标志物潜力方面取得的令人兴奋的进展,并讨论了它们对临床实践的意义。