Current treatment of low grade gliomas

Bent, Martin J. van den; Snijders, Tom J.; Bromberg, Jacoline E C

doi:10.1007/s12254-012-0014-3

Cited by 34 publications

(24 citation statements)

References 40 publications

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“…Patients with GIIG are usually young and often enjoy a good quality of life due to absent or only minor neurological deficits [1], which can be explained by neuroplasticity induced by these slow growing neoplasms [2,3].…”

Section: Introductionmentioning

confidence: 99%

A better surgical resectability of WHO grade II gliomas is independent of favorable molecular markers

et al. 2014

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A higher extent of resection (EOR) in WHO grade II gliomas (GIIG) is correlated with longer survival. However, the molecular markers also feature prognostic relevance. Here, we examined whether maximal EOR was related to the genetic profile. We retrospectively investigated the predictive value of 1p19q, IDH1, 53 expression and Ki67 index for the EOR in 200 consecutive GIIGs (2007-2013). Data were modeled in a linear model. The analysis was performed with two statistical methods (arcsin-sqrt and Beta-regression model with logit link). There was no deletion 1p19q in 118 cases, codeletion 1p19q (57 cases), single deletion 1p (4 cases) or19q (16 cases). 155 patients had a mutation of IDH1. p53 was graded in 4 degrees (0:92 cases, 1:52 cases, 2:31 cases, 3:8 cases). Mean Ki67 index was 5.2 % (range 1-20 %). Mean preoperative tumor volume was 60.8 cm(3) (range 3.3-250 cm(3)) and mean EOR was 0.917 (range 0.574-1). The statistical analysis was significant for a lower EOR in patients with codeletion 1p19q (OR 0.738, p = 0.0463) and with a single deletion 19q (OR 0.641, p = 0.0168). There was no significant correlation between IDH1 or p53 and the EOR. Higher Ki67 was marginally associated with higher EOR (p = 0.0603). The study demonstrates in a large cohort of GIIG that a higher EOR is not attributable to favorable genetic markers. This original result supports maximal surgical resection as an important therapeutic factor per se to optimize prognosis, independently of the molecular pattern.

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Section: Introductionmentioning

confidence: 99%

A better surgical resectability of WHO grade II gliomas is independent of favorable molecular markers

et al. 2014

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“…This discovery is not unexpected, given the highly infiltrative nature of these tumours [77,96,97,191].…”

Section: The Benefits and Risks Of Surgerymentioning

confidence: 98%

“…The only drug on the list published by Kargiotis et al [109] this is not considered to interact with AEDs is temozolomide (TMZ), a less toxic and more-easily tolerated orally-administered drug that effectively crosses the blood-brain barrier [188] and is now commonly used for both high-grade [189] and low-grade [190,191] gliomas, as well as for brain metastases [192] and melanomas, often in combination with radiation therapy. There also is evidence that TMZ itself reduces the frequency of seizures, independent of AED dose.…”

Section: Aeds For Seizure Controlmentioning

confidence: 99%

Seizures in Children with Brain Tumours — Epidemiology, Significance, Management, and Outcomes

Ranger¹,

Diosy²

2015

Molecular Considerations and Evolving Surgical Management Issues in the Treatment of Patients With a Brain Tumor

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“…A large randomized trial showed an increase in time to progression after early RT compared to RT at the time of progression [62] . Early RT (dose of 54 Gy in fractions of 1.8 Gy) improved median progression free survival from 3.4 to 5.3 years, indicating that the timing of RT is less relevant as long as it is given [63] . Reirradiation is frequently employed in recurrent glioma [64] .…”

Section: Radiation Therapymentioning

confidence: 99%

Insights into molecular therapy of glioma: current challenges and next generation blueprint

et al. 2017

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Glioma accounts for the majority of human brain tumors. With prevailing treatment regimens, the patients have poor survival rates. In spite of current development in mainstream glioma therapy, a cure for glioma appears to be out of reach. The infiltrative nature of glioma and acquired resistance substancially restrict the therapeutic options. Better elucidation of the complicated pathobiology of glioma and proteogenomic characterization might eventually open novel avenues for the design of more sophisticated and effective combination regimens. This could be accomplished by individually tailoring progressive neuroimaging techniques, terminating DNA synthesis with prodrug-activating genes, silencing gliomagenesis genes (gene therapy), targeting miRNA oncogenic activity (miRNAmRNA interaction), combining Hedgehog-Gli/Akt inhibitors with stem cell therapy, employing tumor lysates as antigen sources for efficient depletion of tumor-specific cancer stem cells by cytotoxic T lymphocytes (dendritic cell vaccination), adoptive transfer of chimeric antigen receptor-modified T cells, and combining immune checkpoint inhibitors with conventional therapeutic modalities. Thus, the present review captures the latest trends associated with the molecular mechanisms involved in glial tumorigenesis as well as the limitations of surgery, radiation and chemotherapy. In this article we also critically discuss the next generation molecular therapeutic strategies and their mechanisms for the successful treatment of glioma.

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Current treatment of low grade gliomas

Cited by 34 publications

References 40 publications

A better surgical resectability of WHO grade II gliomas is independent of favorable molecular markers

A better surgical resectability of WHO grade II gliomas is independent of favorable molecular markers

Seizures in Children with Brain Tumours — Epidemiology, Significance, Management, and Outcomes

Insights into molecular therapy of glioma: current challenges and next generation blueprint

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