脑室下区相关胶质母细胞瘤:呼吁进行转化研究以指导临床决策

Andrew W. Smith, B. Parashar, A. Wernicke
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引用次数: 6

摘要

胶质母细胞瘤(GBM)是最常见也是最具破坏性的中枢神经系统原发性癌症,大多数患者的预期总生存期约为14个月。尽管进行了广泛的研究,但自2005年使用替莫唑胺以来,GBM的治疗结果基本没有变化。我们认为,为了在治疗管理上取得突破,我们必须开始识别GBM的亚型,并针对特定肿瘤的脆弱性进行量身定制治疗。我们的小组最近研究了针对脑室下区(SVZ)肿瘤的放射治疗的临床结果,SVZ是侧脑室的3-5毫米侧边界,包含成人大脑中最大的神经干细胞集合。我们发现,与不接触SVZ的肿瘤相比,SVZ相关的肿瘤无进展和总生存期更差,并且它们表现出独特的复发和迁移模式。然而,由于对svz相关GBM的基础科学研究很少,目前还无法从遗传学角度确定这组肿瘤的临床行为独特性是否代表了一种真正的疾病亚型。我们认为需要对svz相关的GBM进行进一步的转化研究,以建立治疗概况。
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Subventricular zone–associated glioblastoma: A call for translational research to guide clinical decision making
ABSTRACT Glioblastoma (GBM) is both the most common and the most devastating primary cancer of the central nervous system, with an expected overall survival in most patients of about 14 months. Despite extensive research, outcomes for GBM have been largely unchanged since the introduction of temozolomide in 2005. We believe that in order to achieve a breakthrough in therapeutic management, we must begin to identify subtypes of GBM, and tailor treatment to best target a particular tumor's vulnerabilities. Our group has recently produced an examination of the clinical outcomes of radiation therapy directed at tumors that contact the subventricular zone (SVZ), the 3–5 mm lateral border of the lateral ventricles that contains the largest collection of neural stem cells in the adult brain. We find that SVZ-associated tumors have worse progression free and overall survival than tumors that do not contact the SVZ, and that they exhibit unique recurrence and migration patterns. However, with minimal basic science research into SVZ-associated GBM, it is currently impossible to determine if the clinicobehavioral uniqueness of this group of tumors represents a true disease subtype from a genetic perspective. We believe that further translational research into SVZ-associated GBM is needed to establish a therapeutic profile.
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