Saqib Muhammad, Zahoor Aanus, Rahib Ahmed, Shamim Amna, Mumtaz Hassan
Khyber Medical College, Peshawar, Pakistan.
Bacha Khan Medical College, Mardan, Pakistan.
World Neurosurg X. 2024 Sep 21;24:100399. doi: 10.1016/j.wnsx.2024.100399. eCollection 2024 Oct.
This comprehensive review paper examines the most updated state of research on glioblastoma, an aggressive brain tumor with limited treatment options. By analyzing 76 recent studies, from translational and basic sciences, to clinical trials, we highlight various aspects of glioblastoma and shed light on potential therapeutic strategies. The interplay between tumor cells, neural progenitor cells, and the tumor microenvironment is explored. Targeting the PI3K-Akt-mTOR pathway through extracellular-vesicle (EV)-mediated signaling emerges as a potential therapeutic strategy. Personalized modeling approaches utilizing patient-specific MRI data offer promise for optimizing treatment strategies. The response of glioblastoma stem cells (GSCs) to different treatment modalities is examined, emphasizing the need to inhibit the transformation of proneural (PN) GSCs into resistant mesenchymal (MES) GSCs. Metabolic therapy and combination therapies show potential in reversing treatment resistance and inhibiting both PN and MES GSCs. Immunotherapy, targeted approaches, and molecular dynamics in gliomas are discussed, providing insights into early-stage diagnosis and treatment. Additionally, the potential use of Zika virus as an oncolytic agent is explored. Analysis of phase 0 to 3 clinical trials reveal promising outcomes for various experimental treatments, highlighting the importance of combination therapies, predictive signatures, and patient selection strategies. Specific compounds demonstrate potential therapeutic benefits and tolerability. Phase 3 trials indicate the efficacy of DCVax-L in improving survival rates and depatux-m in prolonging progression-free survival. These findings emphasize the importance of personalized treatment approaches and continued exploration of targeted therapies, immunotherapies, and tumor biology understanding in shaping the future of glioblastoma treatment.
这篇综述性论文考察了胶质母细胞瘤的最新研究状况，胶质母细胞瘤是一种侵袭性脑肿瘤，治疗选择有限。通过分析76项近期研究，从转化医学和基础科学到临床试验，我们突出了胶质母细胞瘤的各个方面，并阐明了潜在的治疗策略。探讨了肿瘤细胞、神经祖细胞和肿瘤微环境之间的相互作用。通过细胞外囊泡（EV）介导的信号传导靶向PI3K-Akt-mTOR途径成为一种潜在的治疗策略。利用患者特异性MRI数据的个性化建模方法为优化治疗策略带来了希望。研究了胶质母细胞瘤干细胞（GSCs）对不同治疗方式的反应，强调了抑制原神经（PN）GSCs向耐药间充质（MES）GSCs转化的必要性。代谢疗法和联合疗法在逆转治疗耐药性以及抑制PN和MES GSCs方面显示出潜力。讨论了胶质瘤中的免疫疗法、靶向方法和分子动力学，为早期诊断和治疗提供了见解。此外，还探索了寨卡病毒作为溶瘤剂的潜在用途。对0期至3期临床试验的分析揭示了各种实验性治疗的良好结果，突出了联合疗法、预测性标志物和患者选择策略的重要性。特定化合物显示出潜在的治疗益处和耐受性。3期试验表明DCVax-L在提高生存率方面的疗效以及depatux-m在延长无进展生存期方面的疗效。这些发现强调了个性化治疗方法的重要性，以及在塑造胶质母细胞瘤治疗未来方面持续探索靶向疗法、免疫疗法和对肿瘤生物学的理解的重要性。
