Journal Article

Challenges and Perspectives of Standard Therapy and Drug Development in High-Grade Gliomas

Paul, Ervin Ashley Lourdes, Kamarudin, Muhamad Noor Alfarizal, Parhar, Ishwar, Chelliah, Shalini Sundramurthi

2021

Overview

Despite their low incidence rate globally, high-grade gliomas (HGG) remain a fatal primary brain tumor. The recommended therapy often is incapable of resecting the tumor entirely and exclusively targeting the tumor leads to tumor recurrence and dismal prognosis. Additionally, many HGG patients are not well suited for standard therapy and instead, subjected to a palliative approach. HGG tumors are highly infiltrative and the complex tumor microenvironment as well as high tumor heterogeneity often poses the main challenges towards the standard treatment. Therefore, a one-fit-approach may not be suitable for HGG management. Thus, a multimodal approach of standard therapy with immunotherapy, nanomedicine, repurposing of older drugs, use of phytochemicals, and precision medicine may be more advantageous than a single treatment model. This multimodal approach considers the environmental and genetic factors which could affect the patient’s response to therapy, thus improving their outcome. This review discusses the current views and advances in potential HGG therapeutic approaches and, aims to bridge the existing knowledge gap that will assist in overcoming challenges in HGG.

• Publisher: MDPI AG,MDPI
• Subject: anaplastic astrocytoma / anaplastic oligodendroglioma / Antineoplastic Agents - chemical synthesis / Antineoplastic Agents - chemistry / Antineoplastic Agents - therapeutic use / Brain cancer / Brain Neoplasms - diagnosis / Brain Neoplasms - therapy / Brain research / Chemotherapy / Clinical trials / Drug Development / Drug dosages / glioblastoma / Glioma / Glioma - diagnosis / Glioma - therapy / high-grade glioma / Humans / Immunotherapy / Medical prognosis / Mutation / oligodendroglioma / Patients / Radiation therapy / Review / Tumors