title: Genomic discoveries in adult astrocytoma.
abstract: Astrocytomas are the most common glial tumor of the central nervous system. Within this category, glioblastoma is the most prevalent and malignant primary brain tumor. Glioblastoma can arise de novo, or through progression from lower-grade lesions, but is uniformly associated with poor outcomes despite surgical resection, chemotherapy, and radiation therapy. Recent genomic discoveries have provided new insight into gliomagenesis and have identified key genetic alterations that have diagnostic, prognostic and predictive capacity. Numerous molecular classification schemes have been proposed to sort tumors into clinically meaningful categories to guide treatment. However, creating therapy targeted towards these alterations has been made challenging by the redundancy of essential signal transduction pathways affected in these tumors, intratumoral heterogeneity, and the hypermutated profiles of recurrent tumors. Future treatment strategies will require a personalized approach with consideration of the unique genetic profile of a specific tumor and the use of multimodality therapies.
authors.affiliation: Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: cbetteg1@jhmi.edu.
authors.forename: Chetan
authors.initials: C
authors.lastname: Bettegowda
mesh_terms: D000328:Adult; D001254:Astrocytoma / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D004265:DNA Helicases / Q000235:genetics / Q000378:metabolism; D066246:ErbB Receptors / Q000235:genetics / Q000378:metabolism; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics / Q000378:metabolism; D058990:Molecular Targeted Therapy; D009154:Mutation; D009687:Nuclear Proteins / Q000235:genetics / Q000378:metabolism; D015398:Signal Transduction; D019098:Telomerase / Q000235:genetics / Q000378:metabolism; D000075924:X-linked Nuclear Protein
chemical_list: D009687:Nuclear Proteins; D007521:Isocitrate Dehydrogenase; C512478:EGFR protein, human; D066246:ErbB Receptors; C509186:TERT protein, human; D019098:Telomerase; D004265:DNA Helicases; C092332:ATRX protein, human; D000075924:X-linked Nuclear Protein