Lucke-Wold Brandon, Rangwala Burhanuddin Sohail, Shafique Muhammad Ashir, Siddiq Mohammad Arham, Mustafa Muhammad Saqlain, Danish Fnu, Nasrullah Rana Muhammad Umer, Zainab Noor, Haseeb Abdul
Department of Neurosurgery, University of Florida, Gainesville, FL 32608, United States.
Department of Neurosurgery, Jinnah Sindh Medical University, Karachi 75510, Pakistan.
World J Clin Oncol. 2024 Apr 24;15(4):482-495. doi: 10.5306/wjco.v15.i4.482.
This comprehensive review delves into the current updates and challenges associated with the management of low-grade gliomas (LGG), the predominant primary tumors in the central nervous system. With a general incidence rate of 5.81 per 100000, gliomas pose a significant global concern, necessitating advancements in treatment techniques to reduce mortality and morbidity. This review places a particular focus on immunotherapies, discussing promising agents such as Zotiraciclib and Lerapolturev. Zotiraciclib, a CDK9 inhibitor, has demonstrated efficacy in glioblastoma treatment in preclinical and clinical studies, showing its potential as a therapeutic breakthrough. Lerapolturev, a viral immunotherapy, induces inflammation in glioblastoma and displays positive outcomes in both adult and pediatric patients. Exploration of immunotherapy extends to Pembrolizumab, Nivolumab, and Entrectinib, revealing the challenges and variabilities in patient responses. Despite promising preclinical data, the monoclonal antibody Depatuxizumab has proven ineffective in glioblastoma treatment, emphasizing the critical need to understand resistance mechanisms. The review also covers the success of radiation therapy in pediatric LGG, with evolving techniques, such as proton therapy, showing potential improvements in patient quality of life. Surgical treatment is discussed in the context of achieving a balance between preserving the patient's quality of life and attaining gross total resection, with the extent of surgical resection significantly influencing the survival outcomes. In addition to advancements in cancer vaccine development, this review highlights the evolving landscape of LGG treatment, emphasizing a shift toward personalized and targeted therapies. Ongoing research is essential for refining strategies and enhancing outcomes in the management of LGG.
本综述深入探讨了与低级别胶质瘤(LGG)管理相关的当前进展和挑战,LGG是中枢神经系统中主要的原发性肿瘤。胶质瘤的总体发病率为每10万人5.81例,是全球关注的重大问题,需要改进治疗技术以降低死亡率和发病率。本综述特别关注免疫疗法,讨论了如佐替西利和莱拉波尔特雷夫等有前景的药物。佐替西利是一种CDK9抑制剂,在临床前和临床研究中已证明对胶质母细胞瘤治疗有效,显示出其作为治疗突破的潜力。莱拉波尔特雷夫是一种病毒免疫疗法,可在胶质母细胞瘤中诱导炎症,并在成人和儿童患者中均显示出积极效果。免疫疗法的探索还涉及帕博利珠单抗、纳武利尤单抗和恩曲替尼,揭示了患者反应中的挑战和变异性。尽管临床前数据很有前景,但单克隆抗体德帕妥昔单抗已被证明在胶质母细胞瘤治疗中无效,这凸显了了解耐药机制的迫切需求。该综述还涵盖了放射疗法在儿童LGG治疗中的成功,随着技术的不断发展,如质子疗法,有望改善患者的生活质量。手术治疗在保持患者生活质量和实现大体全切除之间取得平衡的背景下进行了讨论,手术切除范围对生存结果有显著影响。除了癌症疫苗开发的进展外,本综述强调了LGG治疗格局的不断演变,强调向个性化和靶向治疗的转变。持续的研究对于完善LGG管理策略和提高治疗效果至关重要。
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