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胶质母细胞瘤:针对其病理生理、治疗与创新治疗策略的多学科方法

英文原题:Glioblastoma: A Multidisciplinary Approach to Its Pathophysiology, Treatment, and Innovative Therapeutic Strategies.

查看英文原题

Glioblastoma: A Multidisciplinary Approach to Its Pathophysiology, Treatment, and Innovative Therapeutic Strategies.

PubMed 2025/08/02(内容时间) Biomedicines Q2 · IF 4.5(JCR 2025)

研究概要

胶质母细胞瘤(GBM)是最具侵袭性的原发性脑肿瘤,以进展迅速、高度异质性和对常规治疗耐药为特征。

中文摘要

胶质母细胞瘤(GBM)是侵袭性最强的原发性脑肿瘤,其特点是进展迅速、异质性显著且对常规治疗耐药。本综述综合概述GBM的病理生理学,重点介绍神经炎症、基因改变(如EGFR、PDGFRA)、肿瘤微环境、微生物组相互作用,以及神经节苷脂和鞘脂相关分子失调等关键机制。文章还探讨影像学、组织病理学、免疫组织化学及新兴液体活检技术在改善早期检测和疾病监测中的作用。治疗仍具挑战;标准疗法——手术、放射治疗和替莫唑胺——带来的生存获益有限。目前正在探索并应用多种创新疗法,包括免疫检查点抑制剂、CAR-T细胞疗法、树突状细胞和多肽疫苗,以及溶瘤病毒疗法。文章也讨论纳米技术和个体化医疗的进展,例如个体化多模式免疫治疗和NanoTherm疗法,以期克服血脑屏障和肿瘤异质性的影响。此外,干细胞疗法在靶向递药和免疫调节方面显示出潜力。生酮饮食和姑息治疗等非传统策略也被评估其辅助价值。尽管新疗法前景可期,GBM的复杂性仍要求持续开展跨学科研究,以改善预后、治疗应答和患者生活质量。本综述强调,亟需采用个体化、多模式策略应对这一严重恶性肿瘤。

展开英文摘要原文

Glioblastoma (GBM) is the most aggressive primary brain tumor, characterized by rapid progression, profound heterogeneity, and resistance to conventional therapies. This review provides an integrated overview of GBM's pathophysiology, highlighting key mechanisms such as neuroinflammation, genetic alterations (e.g., EGFR, PDGFRA), the tumor microenvironment, microbiome interactions, and molecular dysregulations involving gangliosides and sphingolipids. Current diagnostic strategies, including imaging, histopathology, immunohistochemistry, and emerging liquid biopsy techniques, are explored for their role in improving early detection and monitoring. Treatment remains challenging, with standard therapies-surgery, radiotherapy, and temozolomide-offering limited survival benefits. Innovative therapies are increasingly being explored and implemented, including immune checkpoint inhibitors, CAR-T cell therapy, dendritic and peptide vaccines, and oncolytic virotherapy. Advances in nanotechnology and personalized medicine, such as individualized multimodal immunotherapy and NanoTherm therapy, are also discussed as strategies to overcome the blood-brain barrier and tumor heterogeneity. Additionally, stem cell-based approaches show promise in targeted drug delivery and immune modulation. Non-conventional strategies such as ketogenic diets and palliative care are also evaluated for their adjunctive potential. While novel therapies hold promise, GBM's complexity demands continued interdisciplinary research to improve prognosis, treatment response, and patient quality of life. This review underscores the urgent need for personalized, multimodal strategies in combating this devastating malignancy.

论文信息

作者
Esparza-Salazar F、Murguiondo-Pérez R、Cano-Herrera G、Bautista-Gonzalez MF、Loza-López EC、Méndez-Vionet A、Van-Tienhoven XA、Chumaceiro-Natera A
单位
Centro de Investigación en Ciencias de La Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac México Campus Norte, Lomas Anáhuac, Huixquilucan 52786, Mexico.Mexico
文献类型
综述
期刊
Biomedicines2025 Aug 2
原文标识
PubMed 40868137 · DOI 10.3390/biomedicines13081882