胶质瘤对BRAF抑制的反应与耐药性:前方的阻碍?

Response and resistance to BRAF inhibition in gliomas: Roadblocks ahead?

作者信息

Capogiri Monica, De Micheli Andrea J, Lassaletta Alvaro, Muñoz Denise P, Coppé Jean-Philippe, Mueller Sabine, Guerreiro Stucklin Ana S

机构信息

Department of Oncology and Children's Research Center, University Children's Hospital of Zurich, Zurich, Switzerland.

Department of Pediatric Hematology and Oncology, Hospital Universitario Niño Jesús, Madrid, Spain.

出版信息

Front Oncol. 2023 Jan 9;12:1074726. doi: 10.3389/fonc.2022.1074726. eCollection 2022.

Abstract

BRAF represents the most common BRAF mutation in all human cancers. Among central nervous system (CNS) tumors, BRAF is mostly found in pediatric low-grade gliomas (pLGG, ~20%) and, less frequently, in pediatric high-grade gliomas (pHGG, 5-15%) and adult glioblastomas (GBM, ~5%). The integration of BRAF inhibitors (BRAFi) in the treatment of patients with gliomas brought a paradigm shift to clinical care. However, not all patients benefit from treatment due to intrinsic or acquired resistance to BRAF inhibition. Defining predictors of response, as well as developing strategies to prevent resistance to BRAFi and overcome post-BRAFi tumor progression/rebound growth are some of the main challenges at present in the field. In this review, we outline current achievements and limitations of BRAF inhibition in gliomas, with a special focus on potential mechanisms of resistance. We discuss future directions of targeted therapy for BRAF mutated gliomas, highlighting how insights into resistance to BRAFi could be leveraged to improve outcomes.

摘要

BRAF是所有人类癌症中最常见的BRAF突变。在中枢神经系统(CNS)肿瘤中,BRAF主要见于儿童低级别胶质瘤(pLGG,约20%),较少见于儿童高级别胶质瘤(pHGG,5 - 15%)和成人胶质母细胞瘤(GBM,约5%)。BRAF抑制剂(BRAFi)应用于胶质瘤患者的治疗给临床护理带来了范式转变。然而,并非所有患者都能从治疗中获益,因为存在对BRAF抑制的固有或获得性耐药。确定反应预测指标,以及制定预防对BRAFi耐药和克服BRAFi治疗后肿瘤进展/反弹生长的策略是该领域目前面临的一些主要挑战。在本综述中,我们概述了BRAF抑制在胶质瘤治疗中的当前成果和局限性,特别关注耐药的潜在机制。我们讨论了BRAF突变型胶质瘤靶向治疗的未来方向,强调如何利用对BRAFi耐药的认识来改善治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e77c/9868954/dd6b8135df76/fonc-12-1074726-g001.jpg

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