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DOI: 10.1055/a-2298-4551
Neues zur Behandlung von Gliomen
News on the treatment of glioma![](https://www.thieme-connect.de/media/10.1055-s-00034916/20240708/lookinside/thumbnails/10-1055-a-2298-4551-1.jpg)
ZUSAMMENFASSUNG
Gegenstand und Ziel Gliome sind die häufigsten hirneigenen Tumore bei Erwachsenen. Traditionellerweise erfolgte die Klassifikation nach histomorphologischen Kriterien. Im Update der Klassifikation der Weltgesundheitsorganisation (WHO) für Tumoren des Zentralnervensystems (ZNS) von 2021 haben molekulare Marker eine noch stärkere Bedeutung für die Einteilung/Diagnose und Behandlung von Gliomen gewonnen.
Material und Methoden Aktuelle Empfehlungen der Deutschen Gesellschaft für Neurologie, der European Association of Neuro-Oncology sowie der nordamerikanischen Society for Neuro-Oncology sind systematisch ausgewertet und synoptisch zusammengetragen worden.
Ergebnisse Neue Entitäten von Gliomen sind definiert worden. Neue Studiendaten sind verfügbar, insbesondere für die Behandlung von Tumoren mit einer Mutation der Isozitrat-Dehydrogenase (IDH). Derzeit untersuchen internationale Studien mögliche neue Therapieansätze.
Schlussfolgerungen Die nachfolgende Übersicht stellt ausgewählte Aspekte der aktuellen multimodalen Behandlung von Gliomen beim Erwachsenen und vielversprechende innovative Ansätze künftiger Entwicklungen heraus.
ABSTRACT
Objective Gliomas are the most common brain tumors in adults. Traditionally, classification was based on histomorphological criteria. According to the 2021 update of the World Health Organization (WHO) classification of tumors of the central nervous system (CNS), molecular markers have become even more important for the classification/diagnosis and treatment of gliomas.
Material and Methods Current recommendations from the Deutsche Gesellschaft für Neurologie, the European Association of Neuro-Oncology and the North American Society for Neuro-Oncology have been systematically evaluated and compiled in synoptic form.
Results New entities of gliomas have been defined. New study data are available, particularly for the treatment of gliomas with a mutation of isocitrate dehydrogenase (IDH). Many (international) studies are currently investigating exciting new therapeutic approaches.
Conclusions The following overview highlights selected aspects of the current multimodal treatment of gliomas in adults and promising innovative approaches for future developments.
Publikationsverlauf
Artikel online veröffentlicht:
17. Juli 2024
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Literatur
- 1 Wick W, Bendszus M, Goldbrunner R. et al Gliome, S2k-Leitlinie.. Berlin: Deutsche Gesellschaft für Neurologie (Hrsg) 2021
- 2 Weller M, van den Bent M, Preusser M. et al EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood.. Nat Rev Clin Oncol 2021; 18: 170-186 DOI: 10.1038/s41571-020-00447-z.
- 3 Miller JJ, Gonzalez Castro LN, McBrayer S. et al Isocitrate dehydrogenase (IDH) mutant gliomas: A Society for Neuro-Oncology (SNO) consensus review on diagnosis, management, and future directions.. Neuro Oncol 2023; 25: 4-25 DOI: 10.1093/neuonc/noac207.
- 4 Wen PY, Weller M, Lee EQ. et al Glioblastoma in adults: a Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions.. Neuro Oncol 2020; 22: 1073-1113 DOI: 10.1093/neuonc/noaa106.
- 5 Louis DN, Perry A, Wesseling P. et al The 2021 WHO Classification of Tumors of the Central Nervous System: a summary.. Neuro Oncol 2021; 23: 1231-1251 DOI: 10.1093/neuonc/noab106.
- 6 Ostrom QT, Cioffi G, Gittleman H. et al CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012–2016. Neuro Oncol 2019; 21: v1-v100 DOI: 10.1093/neuonc/noz150.
- 7 Mohile NA, Messersmith H, Gatson NT. et al Therapy for Diffuse Astrocytic and Oligodendroglial Tumors in Adults: ASCO-SNO Guideline.. J Clin Oncol 2022; 40: 403-426 DOI: 10.1200/JCO.21.02036.
- 8 Buckner JC, Shaw EG, Pugh SL. et al Radiation plus Procarbazine, CCNU, and Vincristine in Low-Grade Glioma.. N Engl J Med 2016; 374: 1344-1355 DOI: 10.1056/NEJMoa1500925.
- 9 van den Bent MJ, Brandes AA, Taphoorn MJ. et al Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951.. J Clin Oncol 2013; 31: 344-350 DOI: 10.1200/JCO.2012.43.2229.
- 10 Cairncross G, Wang M, Shaw E. et al Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402.. J Clin Oncol 2013; 31: 337-343 DOI: 10.1200/JCO.2012.43.2674.
- 11 van den Bent MJ, Tesileanu CMS, Wick W. et al Adjuvant and concurrent temozolomide for 1p/19q non-co-deleted anaplastic glioma (CATNON; EORTC study 26053–22054 second interim analysis of a randomised, open-label, phase 3 study.. Lancet Oncol 2021; 22: 813-823 DOI: 10.1016/S1470-2045(21)00090-5.
- 12 Mellinghoff IK, van den Bent MJ, Blumenthal DT. et al Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma.. N Engl J Med 2023; 389: 589-601 DOI: 10.1056/NEJMoa2304194.
- 13 Herrlinger U, Tzaridis T, Mack F. et al Lomustine-temozolomide combination therapy versus standard temozolomide therapy in patients with newly diagnosed glioblastoma with methylated MGMT promoter (CeTeG/NOA-09): a randomised, open-label, phase 3 trial.. Lancet 2019; 393: 678-688 DOI: 10.1016/S0140-6736(18)31791-4.
- 14 Wick A, Sander A, Koch M. et al Improvement of functional outcome for patients with newly diagnosed grade 2 or 3 gliomas with co-deletion of 1p/19q – IMPROVE CODEL: the NOA-18 trial.. BMC Cancer 2022; 22: 645 DOI: 10.1186/s12885-022-09720-z.
- 15 Stupp R, Mason WP, van den Bent MJ. et al Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.. N Engl J Med 2005; 352: 987-996 DOI: 10.1056/NEJMoa043330.
- 16 Stupp R, Taillibert S, Kanner A. et al Effect of Tumor-Treating Fields Plus Maintenance Temozolomide vs Maintenance Temozolomide Alone on Survival in Patients With Glioblastoma: A Randomized Clinical Trial.. JAMA 2017; 318: 2306-2316 DOI: 10.1001/jama.2017.18718.
- 17 Perry JR, Laperriere N, O’Callaghan CJ. et al Short-Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma.. N Engl J Med 2017; 376: 1027-1037 DOI: 10.1056/NEJMoa1611977.
- 18 Wick W, Platten M, Meisner C. et al Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial.. Lancet Oncol 2012; 13: 707-715 DOI: 10.1016/S1470-2045(12)70164-X.
- 19 Malmstrom A, Gronberg BH, Marosi C. et al Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial.. Lancet Oncol 2012; 13: 916-926 DOI: 10.1016/S1470-2045(12)70265-6.
- 20 Weller M, Le Rhun E. How did lomustine become standard of care in recurrent glioblastoma?. Cancer Treat Rev 2020; 87: 102029 DOI: 10.1016/j.ctrv.2020.102029.
- 21 Wick W, Dettmer S, Berberich A. et al N2M2 (NOA-20) phase I/II trial of molecularly matched targeted therapies plus radiotherapy in patients with newly diagnosed non-MGMT hypermethylated glioblastoma.. Neuro Oncol 2019; 21: 95-105 DOI: 10.1093/neuonc/noy161.
- 22 Alexander BM, Ba S, Berger MS. et al Adaptive Global Innovative Learning Environment for Glioblastoma: GBM AGILE.. Clin Cancer Res 2018; 24: 737-743 DOI: 10.1158/1078-0432.CCR-17-0764.
- 23 Stec NE, Walbert T. Neuro-oncology and supportive care: the role of the neurologist.. Neurol Sci 2022; 43: 939-950 DOI: 10.1007/s10072-021-05862-3.
- 24 Chang SM, Parney IF, Huang W. et al Patterns of care for adults with newly diagnosed malignant glioma.. JAMA 2005; 293: 557-564 DOI: 10.1001/jama.293.5.557.
- 25 Forsyth PA, Weaver S, Fulton D. et al Prophylactic anticonvulsants in patients with brain tumour.. Can J Neurol Sci 2003; 30: 106-112 DOI: 10.1017/s0317167100053361.
- 26 Glantz MJ, Cole BF, Friedberg MH. et al A randomized, blinded, placebo-controlled trial of divalproex sodium prophylaxis in adults with newly diagnosed brain tumors.. Neurology 1996; 46: 985-991 DOI: 10.1212/wnl.46.4.985.
- 27 Rooney AG, McNamara S, Mackinnon M. et al Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma.. J Clin Oncol 2011; 29: 4307-4312 DOI: 10.1200/JCO.2011.34.8466.
- 28 Ruden E, Reardon DA, Coan AD. et al Exercise behavior, functional capacity, and survival in adults with malignant recurrent glioma.. J Clin Oncol 2011; 29: 2918-2923 DOI: 10.1200/JCO.2011.34.9852.
- 29 Derr RL, Ye X, Islas MU. et al Association between hyperglycemia and survival in patients with newly diagnosed glioblastoma.. J Clin Oncol 2009; 27: 1082-1086 DOI: 10.1200/JCO.2008.19.1098.
- 30 Thomas AA, Carver A. Essential competencies in palliative medicine for neuro-oncologists.. Neurooncol Pract 2015; 02: 151-157 DOI: 10.1093/nop/npv011.