Novel chemotherapeutics and other therapies for treating high-grade glioma.
BACKGROUND
Despite extensive research, high-grade glioma (HGG) remains a dire diagnosis with no change in the standard of care in almost a decade. However, recent advancements uncovering molecular biomarkers of brain tumors and tumor-specific antigens targeted by immunotherapies provide opportunities for novel personalized treatment regimens to improve survival.


METHODS
In this review, the authors provide a comprehensive overview of recent therapeutic advancements in HGG. Furthermore, they describe new molecular biomarkers and molecular classifications, in addition to updated research on bevacizumab, targeted molecular therapies, immunotherapy and alternative delivery methods that overcome the blood-brain barrier to reach the target tumor tissue. Challenges regarding each therapy are also outlined. The authors also provide some insight into a novel non-chemotherapeutic treatment for malignant glioma, NovoTTFA, as well as a summary of current treatment options for recurrence.


CONCLUSIONS
Current research for treating malignant gliomas are paving the path to personalized therapy, including immunotherapy, that involve integrated genomic and histolopathologic data, as well as a multi-modal treatment regimen. Immunotherapy will potentially be the next addition to the current standard of care, specialized to the antigens presented on the tumors. The results of the current trials of multi-antigen vaccines are eagerly anticipated.
a 1 Duke University School of Medicine , Box 3807, Durham, NC, USA.
Jennifer H
JH
Kang
b 2 Director, Molecular Neuro-oncology Lab, Duke Medical Center , DUMC Box 3807, Durham, NC, USA.|c 3 Chief of Neurosurgery, Durham VA Medical Center , 508 Fulton Street, Durham, NC, USA +1 919 698 3152 ; cory.adamson@emory.edu.|d 4 Duke Medical Center , DUMC Box 3807, Durham, NC, USA.
Cory
C
Adamson
D000951:Antigens, Neoplasm / Q000276:immunology; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D019496:Cancer Vaccines / Q000008:administration & dosage; D016503:Drug Delivery Systems; D015195:Drug Design; D005910:Glioma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D057285:Precision Medicine / Q000379:methods; D015996:Survival Rate
D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019496:Cancer Vaccines
bevacizumab; chemotherapy; convention enhanced delivery; glioblastoma; high-grade glioma; immunotherapy; nanoparticle; neurosurgery; novo-TTFA; stem cells