Conventional chemotherapy and perspectives for molecular-based oncological treatment in pediatric hemispheric low-grade gliomas

Childs Nerv Syst. 2016 Oct;32(10):1939-45. doi: 10.1007/s00381-016-3132-0. Epub 2016 Sep 20.

Abstract

Introduction: Pediatric low-grade gliomas (PLGG) are the most common primary central nervous system tumor in children. Patients in whom gross total resection can be achieved have an excellent overall (OS) and event-free survival (EFS) and do not require adjuvant therapy. However, children with unresectable tumors often experience multiple progressions and require additional treatment.

Conventional chemotherapy: Radiotherapy results in long-term tumor control, but it is associated with significant toxicity, making chemotherapy the preferred therapeutic option. Several chemotherapy combinations have been found to be successful in PLGG, but 5-year EFS has been below 60 % with most of them.

Molecular-based treatment: Recent molecular advances have led to a better understanding of the molecular pathways involved in the biology of LGG, allowing the development of promising tumor-specific, molecularly targeted therapies.

Keywords: Antiangiogenic agents; Chemotherapy; Molecular targeted theraphy; Pediatric low-grade glioma; Pilocytic astrocytoma; Ras-RAf-MAPK pathway; mTOR pathway.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / genetics*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Glioma / drug therapy*
  • Glioma / genetics*
  • Humans
  • Pediatrics*
  • Signal Transduction / drug effects
  • Signal Transduction / genetics
  • TOR Serine-Threonine Kinases / genetics
  • TOR Serine-Threonine Kinases / metabolism
  • ras Proteins / genetics
  • ras Proteins / metabolism

Substances

  • Antineoplastic Agents
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • ras Proteins