Cruz João Victor Roza, Batista Carolina, Afonso Bernardo de Holanda, Alexandre-Moreira Magna Suzana, Dubois Luiz Gustavo, Pontes Bruno, Moura Neto Vivaldo, Mendes Fabio de Almeida
Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho 373, Centro de Ciências da Saúde, Bloco F, Ilha do Fundão, Cidade Universitária, Rio de Janeiro 21941-590, Brazil.
Instituto Estadual do Cérebro Paulo Niemeyer, Rua do Rezende 156, Rio de Janeiro 20231-092, Brazil.
Cancers (Basel). 2022 Jun 30;14(13):3203. doi: 10.3390/cancers14133203.
Glioblastomas are considered the most common and aggressive primary brain tumor in adults, with an average of 15 months' survival rate. The treatment is surgery resection, followed by chemotherapy with temozolomide, and/or radiotherapy. Glioblastoma must have wild-type IDH gene and some characteristics, such as TERT promoter mutation, EGFR gene amplification, microvascular proliferation, among others. Glioblastomas have great heterogeneity at cellular and molecular levels, presenting distinct phenotypes and diversified molecular signatures in each tumor mass, making it difficult to define a specific therapeutic target. It is believed that the main responsibility for the emerge of these distinct patterns lies in subcellular populations of tumor stem cells, capable of tumor initiation and asymmetric division. Studies are now focused on understanding molecular mechanisms of chemoresistance, the tumor microenvironment, due to hypoxic and necrotic areas, cytoskeleton and extracellular matrix remodeling, and in controlling blood brain barrier permeabilization to improve drug delivery. Another promising therapeutic approach is the use of oncolytic viruses that are able to destroy specifically glioblastoma cells, preserving the neural tissue around the tumor. In this review, we summarize the main biological characteristics of glioblastoma and the cutting-edge therapeutic targets that are currently under study for promising new clinical trials.
胶质母细胞瘤被认为是成人中最常见且侵袭性最强的原发性脑肿瘤,平均生存率为15个月。治疗方法是手术切除,随后进行替莫唑胺化疗和/或放疗。胶质母细胞瘤必须具有野生型异柠檬酸脱氢酶(IDH)基因以及一些特征,如端粒酶逆转录酶(TERT)启动子突变、表皮生长因子受体(EGFR)基因扩增、微血管增殖等。胶质母细胞瘤在细胞和分子水平上具有很大的异质性,每个肿瘤块呈现出不同的表型和多样化的分子特征,这使得难以确定特定的治疗靶点。据信,这些不同模式出现的主要原因在于肿瘤干细胞的亚细胞群体,它们能够启动肿瘤并进行不对称分裂。目前的研究集中在了解化疗耐药的分子机制、肿瘤微环境(由于缺氧和坏死区域)、细胞骨架和细胞外基质重塑,以及控制血脑屏障通透性以改善药物递送。另一种有前景的治疗方法是使用溶瘤病毒,其能够特异性地破坏胶质母细胞瘤细胞,同时保留肿瘤周围的神经组织。在这篇综述中,我们总结了胶质母细胞瘤的主要生物学特征以及目前正在研究用于有望开展新临床试验的前沿治疗靶点。
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