Picca Alberto, Guyon David, Santonocito Orazio Santo, Baldini Capucine, Idbaih Ahmed, Carpentier Alexandre, Naccarato Antonio Giuseppe, Caccese Mario, Lombardi Giuseppe, Di Stefano Anna Luisa
Institut du Cerveau-Paris Brain Institute-ICM, Sorbonne Université, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, 75013 Paris, France.
Department of Medical Oncology, Gustave Roussy University Hospital, 94800 Villejuif, France.
Cancers (Basel). 2022 Feb 22;14(5):1124. doi: 10.3390/cancers14051124.
Diffuse gliomas, the most frequent and aggressive primary central nervous system neoplasms, currently lack effective curative treatments, particularly for cases lacking the favorable prognostic marker mutation. Nonetheless, advances in molecular biology allowed to identify several druggable alterations in a subset of wild-type gliomas, such as and fusions, and hotspot mutations. Multi-tyrosine kinase inhibitors, such as regorafenib, also showed efficacy in the setting of recurrent glioblastoma. IDH inhibitors are currently in the advanced phase of clinical evaluation for patients with -mutant gliomas. Several immunotherapeutic approaches, such as tumor vaccines or checkpoint inhibitors, failed to improve patients' outcomes. Even so, they may be still beneficial in a subset of them. New methods, such as using pulsed ultrasound to disrupt the blood-brain barrier, gene therapy, and oncolytic virotherapy, are well tolerated and may be included in the therapeutic armamentarium soon.
弥漫性胶质瘤是最常见且侵袭性最强的原发性中枢神经系统肿瘤，目前缺乏有效的治愈性治疗方法，尤其是对于缺乏良好预后标志物突变的病例。尽管如此，分子生物学的进展使得在一部分野生型胶质瘤中鉴定出了几种可靶向治疗的改变，例如融合以及热点突变。多酪氨酸激酶抑制剂，如瑞戈非尼，在复发性胶质母细胞瘤的治疗中也显示出疗效。异柠檬酸脱氢酶（IDH）抑制剂目前正处于针对IDH突变型胶质瘤患者的临床评估后期阶段。几种免疫治疗方法，如肿瘤疫苗或检查点抑制剂，未能改善患者的预后。即便如此，它们在一部分患者中可能仍然有益。新的方法，如使用脉冲超声破坏血脑屏障、基因治疗和溶瘤病毒疗法，耐受性良好，可能很快会被纳入治疗手段之中。
