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胶质母细胞瘤的治疗正逐步发生改变:2022 年新的可用药靶和转化前景。

Glioblastoma treatment slowly moves toward change: novel druggable targets and translational horizons in 2022.

机构信息

Department of Oncology, AUSL Bologna, Bologna, Italy.

Nervous System Medical Oncology Department, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy.

出版信息

Expert Opin Drug Discov. 2023 Mar;18(3):269-286. doi: 10.1080/17460441.2023.2174097. Epub 2023 Feb 16.

Abstract

INTRODUCTION

Glioblastoma (GBM) is the most common primary brain tumor in adults. GBM treatment options have been the same for the past 30 years and have only modestly extended survival, despite aggressive multimodal treatments. The progressively better knowledge of GBM biology and a comprehensive analysis of its genomic profile have elucidated GBM heterogeneity, contributing to a more effective molecular classification and to the development of innovative targeted therapeutic approaches.

AREAS COVERED

This article reports all the noteworthy innovations for immunotherapy and targeted therapy, providing insights into the current advances in trial designs, including combination therapies with immuno-oncology agents and target combinations.

EXPERT OPINION

GBM molecular heterogeneity and brain anatomical characteristics critically restrain drug effectiveness. Nevertheless, stimulating insights for future research and drug development come from innovative treatment strategies for GBM, such as multi-specific 'off-the-shelf' CAR-T therapy, oncolytic viral therapy and autologous dendritic cell vaccination. Disappointing results from targeted therapies-clinical trials are mainly due to complex interferences between signaling pathways and biological processes leading to drug resistance: hence, it is imperative in the future to develop combinatorial approaches and multimodal therapies.

摘要

简介

胶质母细胞瘤(GBM)是成人中最常见的原发性脑肿瘤。尽管采用了积极的多模式治疗,但过去 30 年来,GBM 的治疗选择一直没有改变,仅略微延长了患者的生存时间。对 GBM 生物学的深入了解以及对其基因组图谱的全面分析,阐明了 GBM 的异质性,有助于更有效的分子分类,并开发出创新的靶向治疗方法。

涵盖领域

本文报告了所有免疫疗法和靶向治疗的显著创新,深入探讨了目前试验设计的进展,包括免疫肿瘤药物与靶向药物联合治疗。

专家意见

GBM 的分子异质性和大脑解剖学特征严重限制了药物的有效性。然而,针对 GBM 的创新治疗策略,如多特异性“现货”嵌合抗原受体 T 细胞治疗、溶瘤病毒治疗和自体树突状细胞疫苗接种,为未来的研究和药物开发提供了令人鼓舞的思路。靶向治疗临床试验令人失望的结果主要归因于信号通路和生物过程之间的复杂干扰,导致耐药性:因此,未来开发联合治疗方法和多模式治疗至关重要。

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