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胶质母细胞瘤治疗进展:当前治疗策略更新

英文原题:Advances in Glioblastoma Therapy: An Update on Current Approaches.

查看英文原题

Advances in Glioblastoma Therapy: An Update on Current Approaches.

PubMed 2023/10/31(内容时间) Brain Sci Q2 · IF 3.4(JCR 2025)

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中文摘要

多形性胶质母细胞瘤(GBM)是一种原发性恶性脑肿瘤,恶性程度高、预后极差。目前既有GBM治疗疗效不足,亟需迅速开发新的治疗方法。对GBM基础科学认识的进展正在快速转化为更深入的治疗研究。尽管研究者广泛探索新的治疗策略,GBM死亡率仍然很高。肿瘤异质性、血脑屏障、胶质瘤干细胞、药物外排泵及DNA损伤修复机制等因素,导致GBM患者现有治疗效果不佳。针对这些挑战,药物组合疗法显示出日益提高的疗效。包括免疫检查点阻断、CAR-T(CAR-T)细胞疗法、溶瘤病毒疗法及疫苗疗法在内的多种免疫治疗已成为改善GBM预后的潜在策略。目前研究聚焦于探索联合治疗,以减少不良副作用并增强抗肿瘤免疫应答。

此外,临床试验正在评估多种突破血脑屏障(BBB)的方法,以实现复发性GBM患者的靶向递送。本综述介绍GBM治疗的生物学和分子靶点、药物治疗现状、主要耐药机制及新治疗策略;还讨论这些有前景的方法,以评估潜在创新治疗药物,并考察GBM治疗临床前及临床研究的现状。总体而言,本文旨在全面介绍GBM治疗的当前状况。

展开英文摘要原文

Glioblastoma multiforme (GBM) is a primary malignant brain tumor characterized by a high grade of malignancy and an extremely unfavorable prognosis. The current efficacy of established treatments for GBM is insufficient, necessitating the prompt development of novel therapeutic approaches. The progress made in the fundamental scientific understanding of GBM is swiftly translated into more advanced stages of therapeutic studies. Despite extensive efforts to identify new therapeutic approaches, GBM exhibits a high mortality rate.

The current efficacy of treatments for GBM patients is insufficient due to factors such as tumor heterogeneity, the blood-brain barrier, glioma stem cells, drug efflux pumps, and DNA damage repair mechanisms. Considering this, pharmacological cocktail therapy has demonstrated a growing efficacy in addressing these challenges.

Towards this, various forms of immunotherapy, including the immune checkpoint blockade, chimeric antigen receptor T (CAR T) cell therapy, oncolytic virotherapy, and vaccine therapy have emerged as potential strategies for enhancing the prognosis of GBM. Current investigations are focused on exploring combination therapies to mitigate undesirable side effects and enhance immune responses against tumors.

Furthermore, clinical trials are underway to evaluate the efficacy of several strategies to circumvent the blood-brain barrier (BBB) to achieve targeted delivery in patients suffering from recurrent GBM. In this review, we have described the biological and molecular targets for GBM therapy, pharmacologic therapy status, prominent resistance mechanisms, and new treatment approaches.

We also discuss these promising therapeutic approaches to assess prospective innovative therapeutic agents and evaluated the present state of preclinical and clinical studies in GBM treatment.

Overall, this review attempts to provide comprehensive information on the current status of GBM therapy.

论文信息

作者
Angom RS、Nakka NMR、Bhattacharya S
单位
Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, 4500 San Pablo Road South, Jacksonville, FL 32224, USA.United States
文献类型
综述
期刊
Brain sciences2023 Oct 31
原文标识
PubMed 38002496 · DOI 10.3390/brainsci13111536