Title:Current Therapeutic Alternatives and New Perspectives in Glioblastoma Multiforme
Volume: 24
Issue: 25
关键词:
多形性成胶质细胞瘤，烷化剂，MGMT，多重耐药性，MRP-1，免疫治疗。
摘要: Background: In the last two decades, there have been significant technological
advances in the early detection of brain tumors. However, no notable improvements have
been observed in the treatment of Glioblastoma Multiforme (GBM), the most common
brain neoplasm coupled with the worst prognosis. GBM is characterized by an extensive
resistance to a broad spectrum of anti-tumor drugs. This property is the result of a phenomenon
known as Multiple Drug Resistance (MDR), which significantly limits noninvasive
alternative therapies. This limitation is primarily due to the activity of ABC
transporters and proteins related with DNA repair such as the MGMT enzyme. Due to the
high mortality rate in GBM patients and current treatment deficits, new therapeutic strategies
for this type of neoplasm are of vital importance.
Methods: In this review, proposed treatments for GBM, including the use of alkylating
agents with MGMT inhibitors, MDR modulators, and immunotherapies are discussed. We
focused our bibliographic research on papers containing in vitro, in vivo, and clinical
phase analysis published over the last 20 years.
Results: Several studies have demonstrated good results using alkylating agents plus
MGMT inhibitors, although without great improvements in survival. The use of modulators
of ABC transporters enhances the effects of chemotherapy, proving it an effective
complementary therapy. Immunotherapies have undergone significant developments as a
directed and personalized approach for GBM treatment.
Conclusion: The use of alternative complementary therapies discussed in this review
could increase the survival of GBM patients; however, additional clinical phase analysis
and the generation of new treatment protocols are required.
