1. Clinical Management of Diffuse Low-Grade Gliomas
- Author
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Antonella Castellano, Giuseppe Lombardi, Emeline Tabouret, Giulia Cerretti, Vittorina Zagonel, Mario Caccese, Alessandro Salvalaggio, Valeria Barresi, Marta Padovan, Francesco Pasqualetti, Tamara Ius, Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Università degli studi di Verona = University of Verona (UNIVR), Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie] (UniSR), Università degli Studi di Padova = University of Padua (Unipd), Lombardi, G., Barresi, V., Castellano, A., Tabouret, E., Pasqualetti, F., Salvalaggio, A., Cerretti, G., Caccese, M., Padovan, M., Zagonel, V., and Ius, T.
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Review ,Gene mutation ,chemotherapy ,lcsh:RC254-282 ,Targeted therapy ,surgery ,03 medical and health sciences ,0302 clinical medicine ,Chemotherapy ,Diffuse low-grade gliomas ,Radiotherapy ,Surgery ,Internal medicine ,Glioma ,Adjuvant therapy ,Medicine ,Progression-free survival ,radiotherapy ,business.industry ,Astrocytoma ,medicine.disease ,targeted therapy ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,3. Good health ,Radiation therapy ,030220 oncology & carcinogenesis ,diffuse low-grade gliomas ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Oligodendroglioma ,business ,030217 neurology & neurosurgery - Abstract
Simple Summary Diffuse low-grade gliomas (LGG) are relatively uncommon primary brain cancers. In recent years, the molecular, diagnostic, and therapeutic approaches have evolved. IDH (isocitrate dehydrogenase) mutations can affect the great majority of these tumors with distinct genetic and clinical characteristics, carrying a more favorable prognosis compared with wild-type IDH. In patients with LGG, the most common manifestation is seizure and new neuroradiological tools are available to improve the diagnostic and therapeutic pathways. Surgical intervention is performed with the goal of maximum safe resection; postoperative chemoradiotherapy showed benefits in selected patients. New treatments based on molecular profiling, new small molecule and immunotherapy approaches could improve survival and quality of life. In this review, in order to identify the optimal clinical management of patients with LGG, we discuss the relevant biological and clinical characteristics, new therapeutic approaches, and future research directions for these tumors. Abstract Diffuse low-grade gliomas (LGG) represent a heterogeneous group of primary brain tumors arising from supporting glial cells and usually affecting young adults. Advances in the knowledge of molecular profile of these tumors, including mutations in the isocitrate dehydrogenase genes, or 1p/19q codeletion, and in neuroradiological techniques have contributed to the diagnosis, prognostic stratification, and follow-up of these tumors. Optimal post-operative management of LGG is still controversial, though radiation therapy and chemotherapy remain the optimal treatments after surgical resection in selected patients. In this review, we report the most important and recent research on clinical and molecular features, new neuroradiological techniques, the different therapeutic modalities, and new opportunities for personalized targeted therapy and supportive care.
- Published
- 2020