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小儿低级别胶质瘤治疗的进展。

Advances in the Treatment of Pediatric Low-Grade Gliomas.

机构信息

Division of Paediatric Haematology-Oncology, Department of Paediatrics, Hospital for Sick Children, Toronto,, Canada.

出版信息

Curr Neurol Neurosci Rep. 2024 Oct;24(10):527-535. doi: 10.1007/s11910-024-01369-4. Epub 2024 Aug 15.

Abstract

PURPOSE OF REVIEW

Pediatric low-grade gliomas (pLGGs) often result in significant long-term morbidities despite high overall survival rates. This review aims to consolidate the current understanding of pLGG biology and molecular features and provide an overview of current and emerging treatment strategies.

RECENT FINDINGS

Surgical resection remains a primary treatment modality, supplemented by chemotherapy and radiotherapy in specific cases. However, recent advances have elucidated the molecular underpinnings of pLGGs, revealing key genetic abnormalities such as BRAF fusions and mutations and the involvement of the RAS/MAPK and mTOR pathways. Novel targeted therapies, including MEK, BRAF and pan-RAF inhibitors, have shown promise in clinical trials, demonstrating significant efficacy and manageable toxicity. Understanding of pLGGs has significantly improved, leading to more personalized treatment approaches. Targeted therapies have emerged as effective alternatives, potentially reducing long-term toxicities. Future research should focus on optimizing therapy sequences, understanding long-term impacts, and ensuring global accessibility to advanced treatments.

摘要

目的综述

尽管小儿低级别胶质瘤(pLGGs)的总体生存率较高,但仍会导致严重的长期病残。本综述旨在综合目前对 pLGG 生物学和分子特征的认识,并概述当前和新兴的治疗策略。

最近的发现

手术切除仍然是主要的治疗方式,在特定情况下辅以化疗和放疗。然而,最近的进展阐明了 pLGGs 的分子基础,揭示了关键的遗传异常,如 BRAF 融合和突变,以及 RAS/MAPK 和 mTOR 通路的参与。新型靶向治疗,包括 MEK、BRAF 和泛 RAF 抑制剂,在临床试验中显示出良好的疗效和可管理的毒性,具有显著的疗效。对 pLGGs 的认识有了显著提高,导致了更具个性化的治疗方法。靶向治疗已经成为有效的替代方法,可能减少长期毒性。未来的研究应侧重于优化治疗顺序、了解长期影响,并确保全球能够获得先进的治疗方法。

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