Treatment of malignant gliomas: radiotherapy, chemotherapy and integration of new targeted agents.
Progress in the biological and molecular characterization of gliomas and studies of factors associated with tumor growth and progression have led to translational research projects and the development of rational new approaches regarding prognostic models, better prediction of response to treatment and innovative therapeutic strategies. This review summarizes the available data on established and emerging prognostic factors and prognostic scores, and discusses their limitations as well as their potential influence on future therapeutic efforts. Recent developments in standard treatment options (i.e., surgery, radiotherapy and chemotherapy) are reviewed. Experimental data indicate that inhibition of several signaling pathways (e.g., epidermal growth factor, transforming growth factor-beta and phosphatidylinositol 3 kinase) may represent a promising therapeutic strategy. Some inhibitory agents (i.e., drugs, antibodies and antisense oligonucleotides) have now entered clinical trials, mainly for recurrent gliomas and a small number are being tested in combination with radiotherapy. Early results of such approaches are presented.
Nieder
Carsten
C
Department of Radiation Oncology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. klinik-fuer-strahlentherapie@lrz.tu-muenchen.de
Grosu
Anca L
AL
Mehta
Minesh P
MP
Andratschke
Nicolaus
N
Molls
Michael
M
D000970:Antineoplastic Agents / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D016503:Drug Delivery Systems / Q000379:methods*; D005910:Glioma / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D015398:Signal Transduction / Q000187:drug effects
D000970:Antineoplastic Agents