Título del libro: Gliomas: Classification, Symptoms, Treatment And Prognosis
Título del capítulo: Classification, histology, genomic alterations and new therapeutic concepts
JULIO EVERARDO SOTELO MORALES;
Autores externos:
Idioma:
Inglés
Año de publicación:
2014
Resumen:
Gliomas are primary brain tumors of the central nervous system and they are characterized by great cellular heterogeneity. According to the World Health Organization (WHO) classification of primary brain tumors, gliomas are distinguished by morphological criteria that include morphological similarities of the tumor cells with non-neoplastic glial cells, Thusly, they are classified as astrocytic, oligodendroglial, mixed oligo-astrocytic, or ependymal tumors, and they are graded on a scale of I-IV [astrocytic (grade I-IV); oligodendrogliomas (grade II-III); mixed tumors (grade I-III)] with increasing malignancy. Recently, the discovery of several genetic alterations and aberrant signaling pathways has made a considerable contribution to our understanding of the genesis and biology of gliomas. To date, four biomarkers have consistently been associated with diagnosis and prognosis in gliomas: the co-deletion of chromosomes 1p/19q, O6- methylguanine DNA methyltransferase (MGMT) promoter methylation, mutations in isocitrate dehydrogenase (IDH) IDH1/2 genes and amplification of epidermal growth factor receptor (EGFR). Molecular understanding of gliomas is crucial to improve classification, better predict outcome, select patients in clinical trials, and finally provide specific therapy to individual tumor types. On the other hand, treatment of gliomas requires a careful selection of one or more interventions, such as surgery, radiotherapy, and chemotherapy. The prognosis for patients with high-grade gliomas is poor, and it has improved little in recent years. The response to chemotherapy is modest and presents with high toxicities. Radiation therapy is moderately effective and it presents limitations due to collateral radiation damage to healthy brain tissue. Other characteristics that limit the therapy of gliomas is the poor drug delivery and inherent chemo- and radio-resistance. Some investigations are focusing on eliminating residual cells with stem-like characteristics that confer resistance and tumor propagation. Other aspects associated with proliferation and the spread of tumors is their microenvironment. To overcome these limitations in conventional therapy, research in nano- and immune-therapy areas are developing. Nanoparticles are emerging as innovative tools in research and therapies in gliomas due to their capacity of self-assembly, small size, increased stability, biocompatibility, tumor-specific targeting using antibodies or ligands, encapsulation and delivery of antineoplastic drugs, and increasing the contact surface between cells and nanomaterials. The active targeting of nanoparticles through conjugation with cell surface markers could enhance the efficacy of nanoparticles for delivering several agents into the tumoral area while significantly reducing toxicity in living systems. Recent clinical studies have developed immunotherapies based on the expression of tumoral antigens. This treatment uses peptide vaccines to trigger the immune response against the tumor. Additionally, antibody-toxin complexes known as immunotoxins have been designed. These recombinant proteins consist of a specific antibody or ligand coupled to a toxin protein. The toxins used are byproducts of plants, bacteria and fungi that inactivate eukaryotic protein synthesis. Developing new therapeutic agents as adjuvants either alone or in combination with chemotherapy to destroy the tumor cells is the major challenge to improve therapy in the near future. © 2014 by Nova Science Publishers, Inc. All rights reserved.
Entidades citadas de la UNAM:
ISBN:
9781631178757
Editorial:
Nova Science Publishers, Inc. Nombre de la publicación:
Classification, histology, genomic alterations and new therapeutic concepts
Página inicial:
1
Página final:
30
Tipo de producto:
Capítulo de un Libro
