John Wayne Cancer Institute, Santa Monica, CA, USA.
Chin Clin Oncol. 2020 Dec;9(6):77. doi: 10.21037/cco-20-124. Epub 2020 Dec 18.
Glioblastoma remains the most common malignant brain neoplasm in adults. The available therapies for treatment have only modestly extended survival. Traditional chemotherapy agents have shown only slight effectiveness in controlling this disease. The use of molecular profiling has allowed personalized medicine options to be explored for the care of these individuals. Targeted therapies have shown significant benefit in numerous other cancer types with survival being extended significantly. In glioblastoma, several promising markers have been identified including vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR), and programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1). These targets have been shown to play a critical role in glioblastoma formation and proliferation. The pathways of these receptors have been elucidated in detail. This level of understanding has led to the a more robust understanding of possible mechanism of pathway modification. The targeting of these specific markers has led to the development of several selective therapies with additional therapies being evaluated. The clinical trials validating these markers have been promising but have yet to show a clear benefit in brain tumors. This identification of alternative methods to address these markers or identify additional targets may be the key to the fight against this disease. The molecular targeting of glioblastoma pathways may have significant impact on disease control and patient survival.
胶质母细胞瘤仍然是成年人中最常见的恶性脑肿瘤。现有的治疗方法仅略微延长了生存期。传统的化疗药物在控制这种疾病方面仅显示出轻微的效果。分子谱分析的应用允许探索针对这些个体的个性化医疗选择。靶向治疗在许多其他癌症类型中显示出显著的益处,生存期显著延长。在胶质母细胞瘤中,已经确定了几个有前途的标志物,包括血管内皮生长因子(VEGF)、表皮生长因子受体(EGFR)和程序性细胞死亡蛋白 1(PD-1)/程序性死亡配体 1(PD-L1)。这些靶点被证明在胶质母细胞瘤的形成和增殖中起着关键作用。这些受体的途径已被详细阐明。这种理解水平导致对可能的途径修饰机制有了更深入的理解。针对这些特定标志物的靶向治疗已经开发出了几种选择性疗法,并且正在评估更多的疗法。验证这些标志物的临床试验很有希望,但尚未在脑肿瘤中显示出明显的益处。确定替代方法来解决这些标志物或识别其他靶点可能是对抗这种疾病的关键。胶质母细胞瘤途径的分子靶向可能对疾病控制和患者生存产生重大影响。