Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
Expert Rev Anticancer Ther. 2020 May;20(5):355-363. doi: 10.1080/14737140.2020.1757440. Epub 2020 May 12.
: Recent discoveries in the molecular makeup of gliomas, the relationship of certain molecular drivers, and the patient's response to therapy and overall prognosis have resulted in a paradigm shift and redefined our understanding of glioma and revealed potential vulnerabilities within this recalcitrant and lethal disease.: We summarize the current classification of malignant glioma in the context of the historical background, current data-driven treatment strategies, and recent discoveries of the mechanisms of pathogenesis of this disease which recapitulates the developing brain. We describe the relationship to common genetic alterations found in glioma, and possible avenues to exploit these newly revealed mechanisms.: Improved understanding of the molecular underpinnings of this disease has been directly translated into treatment decisions and an improved ability to counsel patients regarding their prognosis. We are beginning to see the first glimmer of a return on the investment in regard to immunotherapy in malignant glioma, with further anticipated successful exploitations of the unique pathophysiology of glioma.
: 最近在神经胶质瘤的分子构成、某些分子驱动因素的关系以及患者对治疗和总体预后的反应方面的发现，导致了范式的转变，重新定义了我们对神经胶质瘤的理解，并揭示了这种顽固和致命疾病的潜在弱点。: 我们总结了恶性神经胶质瘤的当前分类，包括历史背景、当前基于数据的治疗策略以及该疾病发病机制的最新发现，这些发现再现了发育中的大脑。我们描述了与神经胶质瘤中常见遗传改变的关系，以及利用这些新发现的机制的可能途径。: 对这种疾病分子基础的深入了解已直接转化为治疗决策，并提高了向患者提供预后咨询的能力。我们开始看到免疫疗法在恶性神经胶质瘤中的投资回报的初步迹象，预计还将成功利用神经胶质瘤独特的病理生理学。
