Malignant gliomas: old and new systemic treatment approaches

Tanja Mesti; Janja Ocvirk

doi:10.1515/raon-2015-0003

.blurhash-client-img { display: none !important; }

Malignant gliomas: old and new systemic treatment approaches

Radiology and Oncology

Volume 50 (2016): Issue 2 (June 2016)

By: Tanja Mesti and Janja Ocvirk

Open Access

|Apr 2016

Abstract

Background

Malignant (high-grade) gliomas are rapidly progressive brain tumours with very high morbidity and mortality. Until recently, treatment options for patients with malignant gliomas were limited and mainly the same for all subtypes of malignant gliomas. The treatment included surgery and radiotherapy. Chemotherapy used as an adjuvant treatment or at recurrence had a marginal role.

Conclusions

Nowadays, the treatment of malignant gliomas requires a multidisciplinary approach. The treatment includes surgery, radiotherapy and chemotherapy. The chosen approach is more complex and individually adjusted. By that, the effect on the survival and quality of life is notable higher.

References

WHO Classification of tumours of the central nervous system. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, editors. Lyon: IARC Press; 2007.
Search in Google Scholar Back to article
CBTRUS, Central Brain Tumor Registry of the United States. 2007–2008. Primary brain tumors in the United States. Statistical report. 2000– 2004 years of data collected. Available from: http://www.cbtrus.org/ reports/2007-2008/2007report.pdf. Accessed on 10 November 2013.
Search in Google Scholar Back to article
Kase M, Minajeva A, Niinepuu K, Kase S, Vardja M, Asser T, et al. Impact of CD133 positive stem cell proportion on survival in patients with glioblastoma multiforme. Radiol Oncol 2013; 47: 405-10.
Search in Google Scholar Back to article
Fisher JL, Schwartzbaum JA, Wrensch M, Wiemels JL. Epidemiology of brain tumors. Neurol Clin 2007; 25: 867-90.
Search in Google Scholar Back to article
Smrdel U, Kovac V, Popovic M, Zwitter M. Glioblastoma patients in Slovenia from 1997 to 2008. Radiol Oncol 2014; 48: 72-9.
Search in Google Scholar Back to article
Zakelj MP, Zadnik V, Zagar T, Zakotnik B. Survival of cancer patients, diagnosed in 1991-2005 in Slovenia. Ljubljana: Institute of Oncology Ljubljana, Epidemiology and Cancer Registry, Cancer Registry of Republic of Slovenia; 2009. p. 229.
Search in Google Scholar Back to article
Linos E, Raine T, Alonso A, Michaud D. Atopy and risk of brain tumours: a metaanalysis. J Natl Cancer Inst 2007; 99: 1544-50.
Search in Google Scholar Back to article
Wrensch M, Wiencke JK, Wiemels J, Miike R, Patoka J, Moghadassi M, et al. Serum IgE, tumour epidermal growth factor receptor expression and inherited polymorphisms associated with gliomas survival. Cancer Res 2006; 66: 4531-41.
Search in Google Scholar Back to article
Farell CJ, Plotkin SR. Genetic causes of brain tumors: neurofibromatosis, tuberous sclerosis, von Hippel-Lindau and other syndromes. Neurol Clin 2007; 25: 925-46.
Search in Google Scholar Back to article
Schwartzbaum JA, Fisher JL, Kenneth DA, Wrensch M. Epidemiology and molecular pathology of gliomas. Nature 2006; 2: 494-503.
Search in Google Scholar Back to article
Galli R, Binda E, Orfanelli U, Cipelletti B, Gritti A, De Vitis S, et al. Isolation and characterization of tumorigenic, stem-like neural precursors from human glioblastoma. Cancer Res 2004; 64: 7011-21.
Search in Google Scholar Back to article
Singh SK, Hawkins C, Clarke ID, Squire JA, Bayani J, Hide T, et al. Identification of human brain tumor initiating cells. Nature 2004; 432: 396-401.
Search in Google Scholar Back to article
Ueki K, Ono Y, Henson JW, Efird JT, von Deimling A, Louis DN. CDKN2A (p16) or RB alterations occur in majority of glioblastomas and are inversely correlated. Cancer Res 1996; 56: 150-3.
Search in Google Scholar Back to article
Fujisawa H, Kurrer M, Reis RM, Yonekawa Y, Kleihues P, Ohgaki H. Acquisition of the glioblatoma phenotype during astrocytoma progression is associated with loss of heterozygocity on 10q25-qter. Am J Pathol 1999; 155: 387-94.
Search in Google Scholar Back to article
Li J, Yen C, Liaw D, Podsypanina K, Bose S, Wang SI, et al. PTEN, a putative protein tyrosine phosphatase gene mutated in human brain, breast, and prostate cancer. Science 1997; 275: 1943-7.
Search in Google Scholar Back to article
Watanabe K, Tachibana O, Sata K, Yonekawa Y, Kleihues P, Ohgaki H. Overexpression of the EGFR receptor and p53 mutations are mutually exclusive in the evolution of primary and secondary glioblastomas. Brain Pathol 1996; 6: 217-23.
Search in Google Scholar Back to article
Kleihues P, Ohgaki H. Primary and secondary globlastomas: from concept to clinical diagnosis. Neuro Oncol 1999; 1: 44-51.
Search in Google Scholar Back to article
Devaux BC, O’Fallon JR, Kelly PJ. Resection, biopsy, and survival in malignant glial neoplasms. A retrospective study of clinical parameters, therapy and outcome. J Neurosurg 1993; 78: 767-75.
Search in Google Scholar Back to article
Laws ER, Parney IF, Huang W, Anderson F, Morris AM, Asher A, et al. Survival following surgery and prognostic factors for recently diagnosed malignant gliomas: data from the Glioma Outcomes Project. J Neurosurg 2003; 99: 467-73.
Search in Google Scholar Back to article
Lamborn KR, Chang SM, Prados MD. Prognostic factors for survival of patients with glioblastoma: recursive partitioning analysis. Neuro Oncol 2004; 6: 227-35.
Search in Google Scholar Back to article
Gorlia T, van den Bent MJ, Hegi ME, Mirimanoff RO, Weller M, Cairncross JG, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 2698122981/CE.3. Lancet Oncol 2008; 9: 29-38.
Search in Google Scholar Back to article
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJB, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005; 352: 987-96.
Search in Google Scholar Back to article
Hegi ME, Diserens AC, Gorlia T, Hamou MF, de Tribolet N, Weller M, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med 2005; 352: 997-1003.
Search in Google Scholar Back to article
Yan H, Parsons DW, Jin G, McLendon R, Rasheed BA, Yuan W, et al. IDH1 and IDH2 Mutations in Gliomas. N Engl J Med 2009; 360: 765-73.
Search in Google Scholar Back to article
Boisselier B, Marie Y, Labussière M, Ciccarino P, Desestret V, Wang X, et al. COLD PCR HRM: a highly sensitive detection method for IDH1 mutations. Hum Mutat 2010; 31: 1360-5.
Search in Google Scholar Back to article
Labussiere M, Sanson M, Idbaih A, Delattre JY. IDH1 gene mutations: a new paradigm in glioma prognosis and therapy? Oncologist 2010; 15: 196-9.
Search in Google Scholar Back to article
Chang SM, Parney IF, Huang W, Anderson FA Jr, Asher AL, Bernstein M, et al. Patterns of care for adults with newly diagnosed malignant gliomas. JAMA 2005; 293: 557-64.
Search in Google Scholar Back to article
Wen Py, Kesari S. Malignant gliomas in adults. N Engl J Med 2008; 359: 492-507.
Search in Google Scholar Back to article
Wheen LC, Anderson NE, Baker PC, Singh VK, Synek BJ. Leptomeningeal infiltration as the presenting manifestation of a malignant gliomas. J Clin Neurosci 2006; 13: 298-301.
Search in Google Scholar Back to article
Omuro A, DeAngelis LM. Glioblastoma and other malignant gliomas: a clinical review. JAMA 2013; 310: 1842-50.
Search in Google Scholar Back to article
Cha S. Update on brain tumour imaging: from anatomy to phisiology. AJNR Am J Neuroradiol 2006; 27: 475-87.
Search in Google Scholar Back to article
Paleologogs TS, Dorward NL, Wadley JP, Thomas DG. Clinical validation of true frameless stereotactic biopsy: analysis of the first 125 consecutive cases. Neurosurgery 2001; 49: 835-7.
Search in Google Scholar Back to article
Bernays RL, Kollias SS, Khan N, Brandner S, Meier S, Yonekawa Y. Histological yield, complications and technological considerations in 114 consecutive frameless stereotactic biopsy procedures aided by open intraoperative magnetic resonance imageing. J Neurosurg 2002; 97: 354-62.
Search in Google Scholar Back to article
Maza S, Buchert R, Brenner W, Munz DL, Thiel E, Korfel A, et al. Brain and whole-body FDG-PET in diagnosis, treatment monitoring and long-term follow-up of primary CNS lymphoma. Radiol Oncol 2013; 47: 103-10.
Search in Google Scholar Back to article
Pirotte B, Goldman S, Massager N, David P, Wikler D, Vandesteene A, et al. Comparison of 18F-FDG and 11C-methionine for PET-guided stereotactic brain biopsy of gliomas. J Nucl Med 2004; 45: 1293-8.
Search in Google Scholar Back to article
Stupp R, Hegi EM, Mason PW, van den Bent MJ, Taphoorn JBM, Janzer CR, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009; 10: 459-66.
Search in Google Scholar Back to article
Stewart LA. Chemotherapy in adult high-grade gliomas: a systematic review and meta-analysis of individual patient data from 12 randomised trials. Lancet 2002; 359: 1011-8.
Search in Google Scholar Back to article
Westphal M, Hilt DC, Bortey E, Delavault P, Olivares R, Warnke PC, et al. A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant gliomas. Neuro Oncol 2003; 5: 79-88.
Search in Google Scholar Back to article
Westphal M, Ram Z, Riddle V, Hilt D, Bortey E. Gliadel wafer in initial surgery for malignant gliomas: long-term follow-up of a multicenter controlled trial. Acta Neurochir (Wien) 2006; 148: 269-75.
Search in Google Scholar Back to article
Gilbert MR, Dignam J, Won M, Blumenthal DT, Vogelbaum MA, Aldape KD, et al. RTOG 0825: phase III double-blind placebo-controlled trial evaluating bevacizumab (Bev) in patients (Pts) with newly diagnosed glioblastoma (GBM). [Abstract]. 2013 ASCO Annual Meeting. J Clin Oncol 2013; 31(18 Suppl): Abstract No. 1.
Search in Google Scholar Back to article
Henriksson R, Bottomley A, Mason W, Saran F, Wick W, Nishikawa R, et al. Progression-free survival (PFS) and health-related quality of life (HRQoL) in AVAglio, a phase III study of bevacizumab (Bv), temozolomide (T), and radiotherapy (RT) in newly diagnosed glioblastoma (GBM). [Abstract]. 2013 ASCO Annual Meeting. J Clin Oncol 2013; 31(18 Suppl): Abstract No. 2005.
Search in Google Scholar Back to article
Brem SS, Bierman PJ, Brem H, Butowski N, Chamberlain MC, Chiocca EA, et al. Central nervous system cancers. J Natl Compr Canc Netw 2011; 9: 352-400.
Search in Google Scholar Back to article
van den Bent MJ. Anaplastic oligodendroglioma and oligoastrocytoma. Neurol Clin 2007; 25: 1089-109.
Search in Google Scholar Back to article
Jenkins RB, Blair H, Ballman KV, Giannini C, Arusell RM, Law M, et al. A t(1;19)(q10;p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. Cancer Res 2006; 66: 9852-61.
Search in Google Scholar Back to article
Intergroup Radiation Therapy Oncology Group Trial 9402, Cairncross G, Berkey B, Shaw E, Jenkins R, Scheithauer B, et al. Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendroglioma: Intergroup Radiation Therapy Oncology Group Trial 9402. J Clin Oncol 2006; 24: 2707-14.
Search in Google Scholar Back to article
van den Bent MJ, Carpentier AF, Brandes AA, Sanson M, Taphoorn MJ, Bernsen HJ, et al. Adjuvant procarbazine, lomustine, and vincristine improves progression-free survival but not overall survival in newly diagnosed anaplastic oligodendrogliomas and oligoastrocytomas: a randomized European Organisation for Research and Treatment of Cancer phase III trial. J Clin Oncol 2006; 24: 2715-22.
Search in Google Scholar Back to article
Sathorsumetee S, Rich JN, Reardon DA. Diagnosis and treatment of high grade astrocytoma. Neurol Clin 2007; 25: 1111-39.
Search in Google Scholar Back to article
Furnari FB, Fenton T, Bachoo RM, Mukasa A, Stommel JM, Stegh A, et al. Malignant astrocytic glioma: genetics, biology, and paths to treatment. Genes Dev 2007; 21: 2683-710.
Search in Google Scholar Back to article
Chi AS, Wen PY. Inhibiting kinases in malignant gliomas. Expert Opin Ther Targets 2007; 11: 473-96.
Search in Google Scholar Back to article
Sathorsumetee S, Reardon DA, Desjardins A, Quinn JA, Vredenburgh JJ, Rich JN. Molecularly targeted therapy for malignant gliomas. Cancer 2007; 110: 13-24.
Search in Google Scholar Back to article
Fiegler W, Langer M, Scheer M, Kazner E. [Reversible computed tomographic changes following brain tumour irradiation induced by the “early-delayed reaction” after radiation]. [German]. Radiologe 1986; 26: 206-9.
Search in Google Scholar Back to article
Watne K, Hager B, Heier M, Hirschberg H. Reversible oedema and necrosis after irradiation of the brain. Diagnostic procedures and clinical manifestations. Acta Oncol 1990; 29: 891-5.
Search in Google Scholar Back to article
Griebel M, Friedman HS, Halperin EC, Wiener MD, Marks L, Oakes WJ, et al. Reversible neurotoxicity following hyperfractionated radiation therapy of brain stem gliomas. Med Pediatr Oncol 1991; 19: 182-6.
Search in Google Scholar Back to article
de Wit MC, de Bruin HG, Eijkenboom W, Sillevis Smitt PA, van den Bent MJ. Immediate post-radiotherapy changes in malignant gliomas can mimic tumour progression. Neurology 2004; 63: 535-7.
Search in Google Scholar Back to article
Taal W, Brandsma D, de Bruin HG, Bromberg JE, Swaak-Kragten AT, Smitt PA, et al. The incidence of pseudoprogression in a cohort of malignant gliomas patients treated with chemo-radiation with temozolomide. [Abstract]. Proc Am Soc Clin Oncol 2007; 25: Abstract No. 2009.
Search in Google Scholar Back to article
Brandes AA, Franceschi E, Tosoni A, Blatt V, Pession A, Tallini G, et al. MGMT promoter methylation status can predict the incidence and outcome of pseudoprogression after concomitant radiochemotherapy in newly diagnosed glioblastoma patients. J Clin Oncol 2008; 26: 2192-7.
Search in Google Scholar Back to article
Kos N, Kos B, Benedicic M. Early medical rehabilitation after neurosurgical treatment of malignant brain tumours in Slovenia. Radiol Oncol 2015; 49: in press.
Search in Google Scholar Back to article
Keles GE, Lamborn KR, Chang SM, Prados MD, Berger MS. Volume of residual disease as a predictor of outcome in adult patients with recurrent supratentorial glioblastomas multiforme who are undergoing chemotherapy. J Neurosurg 2004; 100: 41-6.
Search in Google Scholar Back to article
Tsao MN, Mehta MP, Whelan TJ, Morris DE, Hayman JA, Flickinger JC, et al. The American Society for Therapeutic Radiology and Oncology (ASTRO) evidence-based review of the role of radiosurgery for malignant gliomas. Int J Radiat Oncol Biol Phys 2005; 63: 47-55.
Search in Google Scholar Back to article
Combs SE, Thilmann C, Edler L, Debus J, Schulz-Ertner D. Efficacy of fractionated stereotactic reirradiation in recurrent gliomas: long-term results in 172 patients treated in a single institution. J Clin Oncol 2005; 23: 8863-9.
Search in Google Scholar Back to article
Kong DS, Lee JI, Park K, Kim JH, Lim DH, Nam DH. Efficacy of stereotactic radiosurgery as a salvage treatment for recurrent malignant gliomas. Cancer 2008; 112: 2046-51.
Search in Google Scholar Back to article
Prados MD, Yung WKA, Fine HA, Greenberg HS, Junck L, Chang SM, et al. Phase 2 study of BCNU and temozolomide for recurrent glioblastoma multiforme: North American Brain Tumor Consortium study. Neuro Oncol 2004; 6: 33-7.
Search in Google Scholar Back to article
Wong ET, Hess KR, Gleason MJ, Jaeckle KA, Kyritsis AP, Prados MD, et al. Outcomes and prognostic factors in recurrent gliomas patients enrolled onto phase II clinical trials. J Clin Oncol 1999; 17: 2572-8.
Search in Google Scholar Back to article
Yung WK, Albright RE, Olson J, Fredericks R, Fink K, Prados MD, et al. A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse. Br J Cancer 2000; 83: 588-93.
Search in Google Scholar Back to article
Brock CS, Newlands ES, Wedge SR, Bower M, Evans H, Colquhoun I, et al. Phase I trial of temozolomide using an extended continuous oral schedule. Cancer Res 1998; 58: 4363-7.
Search in Google Scholar Back to article
Tolcher AW, Gerson SL, Denis L, Geyer C, Hammond LA, Patnaik A, et al. Marked inactivation of O6-alkylguanine-DNA alkyltransferase activity with protracted temozolomide schedules. Br J Cancer 2003; 88: 1004-11.
Search in Google Scholar Back to article
Wick W, Steinbach JP, Kuker WM, Dichgans J, Bamberg M, Weller M. One week on/one week off: a novel active regimen of temozolomide for recurrent glioblastoma. Neurology 2004; 62: 2113-5.
Search in Google Scholar Back to article
Su YB, Sohn S, Krown SE, Livingston PO, Wolchok JD, Quinn C, et al. Selective CD4+ lymphopenia in melanoma patients treated with temozolomide: a toxicity with therapeutic implications. J Clin Oncol 2004; 22: 610-6.
Search in Google Scholar Back to article
Wick W, Weller M. How lymphotoxic is dose-intensified temozolomide? The glioblastoma experience. J Clin Oncol 2005; 23: 4235-6; author reply 4236.
Search in Google Scholar Back to article
Brandes AA, Tosoni A, Amistà P, Nicolardi L, Grosso D, Berti F, et al. How effective is BCNU in recurrent glioblastoma in the modern era? A phase II trial. Neurology 2004; 63: 1281-4.
Search in Google Scholar Back to article
Schmidt F, Fischer J, Herrlinger U, Dietz K, Dichgans J, Weller M. PCV chemotherapy for recurrent glioblastoma. Neurology 2006; 66: 587-9.
Search in Google Scholar Back to article
Kreisl TN, Kim L, Moore K, Duic P, Royce C, Stroud I, et al. Phase II trial of single-agent bevacizumab followed by bevacizumab plus irinotecan at tumor progression in recurrent glioblastoma. J Clin Oncol 2009; 27: 740-5.
Search in Google Scholar Back to article
Friedman HS, Prados MD, Wen PY, Mikkelsen T, Schiff D, Abrey LE, et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol 2009; 27: 4733-40.
Search in Google Scholar Back to article
Cloughesy T, Vredenburgh JJ, Day B, Das A, Friedman HS. Updated safety and survival of patients with relapsed glioblastoma treated with bevacizumab in the BRAIN study. [Abstract]. J Clin Oncol 2010; 28(15 Suppl): Abstract No. 3085.
Search in Google Scholar Back to article
NCCN clinical practical guidelines in oncology. Central nervous system cancer. Version 2.2013. Available from: http://www.nccn.org/professionals/ physician_gls/f_guidelines.asp#site. Accessed on 7 August 2012.
Search in Google Scholar Back to article
Stupp R, Tonn JC, Brada M, Pentheroudakis G. High grade malignant glioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21(Suppl 5): v190-3.
Search in Google Scholar Back to article
Mesti T, Ebert Moltara M, Boc M, Reberšek M, Ocvirk J. Bevacizumab and irinotecan in recurrent malignant glioma, a single institution experience. Radiol Oncol 2014. Ahead of print. doi:10.2478/raon-2014-0021
Open DOI Search in Google Scholar Back to article
Wick W, Engel C, Combs SE, Nikkhah G, Steinbach J, Kortmann R, et al. NOA08 randomized phase III trial of 1 week on/1 week off temozolomide versus involved-field radiotherapy in elderly (older than age 65) patients with newly diagnosed anaplastic astrocytoma or glioblastoma (Methusalem). [Abstract]. J Clin Oncol 2010; 28: 949s. Abstract No. LBA2001.
Search in Google Scholar Back to article
Keime-Guibert F, Chinot O, Taillandier L, Cartalat-Carel S, Frenay M, Kantor G, et al. Radiotherapy for glioblastoma in the elderly. N Engl J Med 2007; 356: 1527-35.
Search in Google Scholar Back to article
Roa W, Brasher PM, Bauman G, Anthes M, Bruera E, Chan A, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol 2004; 22: 1583-8.
Search in Google Scholar Back to article
Glantz M, Chamberlain M, Liu Q, Litofsky NS, Recht LD. Temozolomide as an alternative to irradiation for elderly patients with newly diagnosed malignant gliomas. Cancer 2003; 97: 2262-6.
Search in Google Scholar Back to article
Malmstrom A, Gronberg BH, Stupp R, Marosi C, Frappaz D, Schultz HP, et al. Glioblastoma (GBM) in elderly patients: a randomized phase III trial comparing survival in patients treated with 6-week radiotherapy (RT) versus hypofractionated RT over 2 weeks versus temozolomide single agent chemotherapy (TMZ) for glioblastoma (GBM) in the elderly. [Abstract]. J Clin Oncol 2010; 28(18 Suppl): 949s. Abstract No. LBA2002
Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.1515/raon-2015-0003 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

Journal RSS Feed

Language: English

Page range: 129 - 138

Submitted on: Jun 30, 2014

Accepted on: Sep 29, 2014

Published on: Apr 23, 2016

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

Related subjects:

Haematology, oncology,

Radiology

© 2016 Tanja Mesti, Janja Ocvirk, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 50 (2016): Issue 2 (June 2016)