The role of Gliadel wafers in the treatment of high-grade gliomas

Bregy, Amadé; Shah, Ashish H.; Díaz, María Victoria; Pierce, Hayley E; Ames, Philip L; Diaz, David; Komotar, Ricardo J.

doi:10.1586/14737140.2013.840090

Cited by 153 publications

(118 citation statements)

References 30 publications

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“…Standard treatment includes surgery, radiotherapy, and chemotherapy [1][2][3][4]. Prognosis is dismal, with an average survival of ∼ 12 months; despite the rapid advancements in technology and new insights in therapy and nursing care, the poor prognosis has remained during the past centuries [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…Glioma is one of the most common malignant tumors in the brain, with a median survival of 12 months; despite the rapid advancement of technology and new insights in therapy and nursing care, poor prognosis has remained during the past centuries, in particular, in the case of glioblastoma [1][2][3][4][5]. Therefore, it is essential to investigate the mechanism of its development, progression, and cure.…”

Section: Introductionmentioning

confidence: 99%

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MiR-27a regulates Wnt/beta-catenin signaling through targeting SFRP1 in glioma

Wang

Xie²,

Xie³

et al. 2015

NeuroReport

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Glioma is one of the most common intracranial tumors, and the prognosis is poor, although more and more treatments are employed. Wnt/beta-catenin signaling has been reported to be associated with glioma. SFRP1 acts as an antagonist and inhibits Wnt signaling by binding to Wnt molecules. In the present study, we aimed to investigate miRNA-27a as an antineoplastic factor that inhibits the Wnt/beta-catenin pathway by binding to the SFRP1 3'-UTR in glioma in vitro. We first showed that the expression of miR-27a was elevated in both glioma samples and cell lines. Furthermore, downregulation of miR-27a induced growth inhibition, cycle arrest, and apoptosis, and suppressed invasion/migration in glioma cell lines. Quantitative real-time PCR, western blot, and luciferase assay analysis showed that SFRP1 is a direct target of miR-27a. Overexpression of SFRP1 inhibited the malignancy of glioma cell lines. Our investigation showed that downregulation of miR-27a suppressed beta-catenin/TCF-4 transcription activity by targeting SFRP1. Our findings identify a role for miR-27a in glioma cell viability, cycle, apoptosis, and invasion/migration after activation of Wnt/beta-catenin signaling through SFRP1.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MiR-27a regulates Wnt/beta-catenin signaling through targeting SFRP1 in glioma

Wang

Xie²,

Xie³

et al. 2015

NeuroReport

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“…Nevertheless, the use of carmustine wafers remains controversial due to the questionable survival benefit and potential adverse events (50).…”

Section: Gliadel (Carmustine) Implantable Wafersmentioning

confidence: 99%

Current Standards of Care in Glioblastoma Therapy

et al. 2017

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Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Regardless of ideal multidisciplinary treatment, including maximal surgical resection, followed by radiotherapy plus concomitant and maintenance temozolomide (TMZ), almost all patients experience tumor progression with nearly universal mortality and a median survival of less than 15 months. The addition of bevacizumab to standard treatment with TMZ revealed no increase in overall survival (OS) but improved progression-free survival (PFS). In newly diagnosed GBM, methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter has been shown to predict response to alkylating agents, as well asgnosis. Therefore, MGMT promoter status may have a crucial role in the choice of single modality treatment in fragile elderly population. No standard of care is established in recurrent or progressive GBM. Treatment alternatives may include supportive care, surgery, re-irradiation, systemic therapies, and combined modality therapy. Despite numerous clinical trials, the identification of effective therapies is complex because of the lack of appropriate control arms, selection bias, small sample sizes, and disease heterogeneity. Tumor-treating fields plus TMZ represent a major advance in the field of GBM therapy, and should be Standards of Care in Glioblastoma Therapy 198 considered for patients with newly diagnosed GBM with no contraindications. As a disease with such a poor prognosis, treatment of GBM should go beyond improving survival and aim at preserving and even improving the quality of life of both the patient and the caregiver.

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“…35,36 Bis-chloroetheylnitrosourea (BCNU) wafers placed in the brain tumor resection cavity increase local drug delivery; however, this treatment method has associated complications and generates MRI artifact. 6 Convection-enhanced delivery slowly infuses drugs using surgically placed small-diameter catheters to saturate the target site and limit regional spread. 14 The limitations of these drug-to-brain delivery approaches have led to the search for safe, less invasive, and more effective alternatives.…”

Section: Background the Blood-brain And Blood-tumor Barriersmentioning

confidence: 99%

A review of potential applications of MR-guided focused ultrasound for targeting brain tumor therapy

Lamsam¹,

Johnson²,

Connolly³

et al. 2018

Neurosurgical Focus

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Magnetic resonance–guided focused ultrasound (MRgFUS) has been used extensively to ablate brain tissue in movement disorders, such as essential tremor. At a lower energy, MRgFUS can disrupt the blood-brain barrier (BBB) to allow passage of drugs. This focal disruption of the BBB can target systemic medications to specific portions of the brain, such as for brain tumors. Current methods to bypass the BBB are invasive, as the BBB is relatively impermeable to systemically delivered antineoplastic agents. Multiple healthy and brain tumor animal models have suggested that MRgFUS disrupts the BBB and focally increases the concentration of systemically delivered antitumor chemotherapy, immunotherapy, and gene therapy. In animal tumor models, combining MRgFUS with systemic drug delivery increases median survival times and delays tumor progression. Liposomes, modified microbubbles, and magnetic nanoparticles, combined with MRgFUS, more effectively deliver chemotherapy to brain tumors. MRgFUS has great potential to enhance brain tumor drug delivery, while limiting treatment toxicity to the healthy brain.

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The role of Gliadel wafers in the treatment of high-grade gliomas

Cited by 153 publications

References 30 publications

MiR-27a regulates Wnt/beta-catenin signaling through targeting SFRP1 in glioma

MiR-27a regulates Wnt/beta-catenin signaling through targeting SFRP1 in glioma

Current Standards of Care in Glioblastoma Therapy

A review of potential applications of MR-guided focused ultrasound for targeting brain tumor therapy

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