PDF(Pubmed)
Abstract：
High-grade glial tumors (HGGs) exhibit aggressive growth patterns and high recurrence rates. The prevailing treatment approach comprises radiation therapy (RT), chemotherapy (CMT), and surgical resection. Despite the progress made in traditional treatments, the outlook for patients with HGGs remains bleak. Tumor metabolism is emerging as a potential target for glioma therapies, a promising approach that harnesses the metabolism to target tumor cells. However, the efficacy of therapies targeting the metabolism of HGGs remains unclear, compelling a comprehensive review. This study aimed to assess the outcome of present trials on HGG therapies targeting metabolism. A comprehensive search of PubMed, Ovid MEDLINE, and Ovid EMBASE was conducted until November 2023. The search method used pertinent Medical Subject Heading (MeSH) terminologies and keywords referring to \"high-grade gliomas\", \"metabolism\", \"target therapies\", \"monoclonal antibodies\", \"overall survival\", and \"progression-free survival\". The review analyzed studies that focused on therapies targeting the metabolism of HGGs in human subjects. These studies included both randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs). Out of 284 articles identified, 23 trials met the inclusion criteria and were thoroughly analyzed. Phase II trials were the most numerous (62%). Targeted metabolic therapies were predominantly used for recurrent HGGs (67%). The most common targeted pathways were the vascular endothelial growth factor (VEGF, 43%), the human epidermal growth factor receptor (HER, 22%), the platelet-derived growth factor (PDGF, 17%), and the mammalian target of rapamycin (mTOR, 17%). In 39% of studies, the subject treatment was combined with CMT (22%), RT (4%), or both (13%). The median OS widely ranged from 4 to 26.3 months, while the median PFS ranged from 1.5 to 13 months. This systematic literature review offers a thorough exploration of the present state of metabolic therapies for HGGs. The multitude of targeted pathways underscores the intricate nature of addressing the metabolic aspects of these tumors. Despite existing challenges, these findings provide valuable insights, guiding future research endeavors. The results serve as a foundation for refining treatment strategies and enhancing patient outcomes within the complex landscape of HGGs.
摘要：
高级别神经胶质肿瘤（HGG）表现出积极的生长模式和高复发率。目前的治疗方法包括放射治疗（RT），化疗（CMT），和手术切除。尽管传统治疗方法取得了进展，HGG患者的前景依然黯淡。肿瘤代谢正在成为神经胶质瘤治疗的潜在靶点，一种有希望的方法，利用新陈代谢靶向肿瘤细胞。然而,针对HGG代谢的疗法的疗效尚不清楚，令人信服的全面审查。本研究旨在评估目前针对HGG疗法靶向代谢的试验结果。全面搜索PubMed,OvidMEDLINE,OvidEMBASE一直持续到2023年11月。搜索方法使用相关的医学主题标题（MeSH）术语和关键词，指的是“高级别神经胶质瘤”，“新陈代谢”，“目标疗法”，“单克隆抗体”，“总生存率”，和“无进展生存期”。该综述分析了专注于针对人类受试者中HGs代谢的疗法的研究。这些研究包括随机对照试验（RCTs）和非随机对照试验（NRCTs）。在确认的284篇文章中，23项试验符合纳入标准，并进行了彻底分析。II期试验数量最多（62%）。靶向代谢疗法主要用于复发性HGG(67%)。最常见的靶向途径是血管内皮生长因子（VEGF，43%），人类表皮生长因子受体（HER，22%），血小板衍生生长因子(PDGF，17%），和哺乳动物雷帕霉素靶蛋白(mTOR，17%）。在39%的研究中,受试者治疗联合CMT（22%），RT（4%），或两者（13％）。中位OS范围从4到26.3个月，而中位PFS为1.5~13个月.这篇系统的文献综述为HGs的代谢疗法的现状提供了彻底的探索。多种靶向途径强调了解决这些肿瘤的代谢方面的复杂性质。尽管存在挑战,这些发现提供了有价值的见解，指导未来的研究工作。该结果为在复杂的HGs环境中完善治疗策略和增强患者预后奠定了基础。
