Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.
Curr Med Chem. 2020;27(4):599-629. doi: 10.2174/0929867326666190809221332.
Glioma, especially its most malignant type, Glioblastoma (GBM), is the most common and the most aggressive malignant tumour in the central nervous system. Currently, we have no specific therapies that can significantly improve its dismal prognosis. Recent studies have reported promising in vitro experimental results of several novel glioma-targeting drugs; these studies are encouraging to both researchers and patients. However, clinical trials have revealed that novel compounds that focus on a single, clear glioma genetic alteration may not achieve a satisfactory outcome or have side effects that are unbearable. Based on this consensus, phytochemicals that exhibit multiple bioactivities have recently attracted much attention. Traditional Chinese medicine and traditional Indian medicine (Ayurveda) have shown that phytocompounds inhibit glioma angiogenesis, cancer stem cells and tumour proliferation; these results suggest a novel drug therapeutic strategy. However, single phytocompounds or their direct usage may not reverse comprehensive malignancy due to poor histological penetrability or relatively unsatisfactory in vivo efficiency. Recent research that has employed temozolomide combination treatment and Nanoparticles (NPs) with phytocompounds has revealed a powerful dual-target therapy and a high blood-brain barrier penetrability, which is accompanied by low side effects and strong specific targeting. This review is focused on major phytocompounds that have contributed to glioma-targeting treatment in recent years and their role in drug resistance inhibition, as well as novel drug delivery systems for clinical strategies. Lastly, we summarize a possible research strategy for the future.
神经胶质瘤，特别是其最恶性的类型——胶质母细胞瘤（GBM），是中枢神经系统中最常见和最具侵袭性的恶性肿瘤。目前，我们没有特定的治疗方法可以显著改善其预后不良的情况。最近的研究报告了几种新型神经胶质瘤靶向药物的有前途的体外实验结果；这些研究结果令研究人员和患者都感到鼓舞。然而，临床试验表明，专注于单一明确的神经胶质瘤遗传改变的新型化合物可能无法取得满意的结果，或者具有难以忍受的副作用。基于这一共识，具有多种生物活性的植物化学物质最近引起了广泛关注。中药和印度传统医学（阿育吠陀）表明，植物化合物可抑制神经胶质瘤血管生成、癌症干细胞和肿瘤增殖；这些结果表明了一种新的药物治疗策略。然而，由于较差的组织穿透性或相对不理想的体内效率，单一植物化合物或其直接使用可能无法逆转全面恶性。最近的研究采用替莫唑胺联合治疗和含有植物化合物的纳米颗粒（NPs），揭示了一种强大的双重靶向治疗方法和高血脑屏障穿透性，同时具有低副作用和强烈的特异性靶向性。本综述重点介绍了近年来在神经胶质瘤靶向治疗中发挥作用的主要植物化合物及其在抑制耐药性方面的作用，以及用于临床策略的新型药物递送系统。最后，我们总结了未来可能的研究策略。
