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Overall Management
> Astrocytic
Tumors |
Treatment >
Treatment Surveys
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Journal of Clinical Oncology, Vol 24, No 8 (March 10), 2006: pp.
1253-1265.
DOI: 10.1200/JCO.2005.04.5302
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Abstract |
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Recent Advances in the Treatment of
Malignant Astrocytoma
David A. Reardon, Jeremy
N. Rich, Henry S. Friedman, Darell D. Bigner
From the Departments of Surgery,
Pediatrics, and Pathology, Duke University Medical Center, Durham, NC
-- Address reprint requests to David A. Reardon, the Preston Robert
Tisch Brain Tumor Center at Duke University, Duke University Medical
Center, Box 3624, Durham, NC 27710; e-mail: reard003@mc.duke.edu
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Malignant gliomas, including the most
common subtype, glioblastoma multiforme (GBM), are among
the most devastating of neoplasms.
Their aggressive infiltration in the CNS typically produces progressive
and profound disability—ultimately leading to death in
nearly all cases.
Improvement in outcome has been elusive despite decades of
intensive clinical and laboratory research.
Surgery and radiotherapy, the traditional cornerstones of
therapy, provide palliative benefit, while the value of chemotherapy
has been marginal and controversial.
Limited delivery and tumor heterogeneity are two
fundamental factors that have critically hindered
therapeutic progress.
A novel chemoradiotherapy approach, consisting of
temozolomide administered concurrently during radiotherapy
followed by adjuvant systemic temozolomide, has recently
demonstrated a meaningful, albeit modest, improvement in
overall survival for newly diagnosed GBM patients.
As cell-signaling alterations linked to the development and
progression of gliomas are being increasingly elucidated,
targeted therapies have rapidly entered preclinical and
clinical evaluation.
Responses to therapies that function via DNA damage have
been associated with specific mediators of resistance that
may also be subject to targeted therapies.
Other approaches include novel locoregional delivery techniques
to overcome barriers of delivery.
The simultaneous development of multiple advanced therapies
based on specific tumor biology may finally offer glioma
patients improved survival.
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© 2006 American Society of Clinical
Oncology
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Abstract
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