Abstract:
Glioblastoma is the most common and lethal central nervous system malignancy with a median survival after progression of only 6-9 months. Major biochemical mechanisms implicated in glioblastoma recurrence include aberrant molecular pathways, a recurrence-inducing tumor microenvironment, and epigenetic modifications. Contemporary standard-of-care (surgery, radiation, chemotherapy, and tumor treating fields) helps to control the primary tumor but rarely prevents relapse. Cytoreductive treatment such as surgery has shown benefits in recurrent glioblastoma; however, its use remains controversial. Several innovative treatments are emerging for recurrent glioblastoma, including checkpoint inhibitors, chimeric antigen receptor T cell therapy, oncolytic virotherapy, nanoparticle delivery, laser interstitial thermal therapy, and photodynamic therapy. This review seeks to provide readers with an overview of (1) recent discoveries in the molecular basis of recurrence; (2) the role of surgery in treating recurrence; and (3) novel treatment paradigms emerging for recurrent glioblastoma.
摘要:
胶质母细胞瘤是最常见和致命的中枢神经系统恶性肿瘤,其进展后的中位生存期仅为6-9个月。胶质母细胞瘤复发的主要生化机制包括异常的分子途径,诱发复发的肿瘤微环境,和表观遗传修饰。当代护理标准(手术,辐射,化疗,和肿瘤治疗领域)有助于控制原发性肿瘤,但很少防止复发。手术等细胞减灭术治疗对复发性胶质母细胞瘤有益处;然而,它的使用仍然存在争议。复发性胶质母细胞瘤正在出现几种创新的治疗方法,包括检查点抑制剂,嵌合抗原受体T细胞疗法,溶瘤病毒疗法,纳米颗粒递送,激光间质热疗,和光动力疗法。这篇综述旨在为读者提供以下概述:(1)复发分子基础的最新发现;(2)手术在治疗复发中的作用;(3)复发性胶质母细胞瘤的新治疗范例。