Neuro-Oncology
Reviews


Volume 22 Number 10
October 2020


Home > Publications > Neuro-Oncology Reviews > Volume 22, Year 2020 > Number 10, October




The list of articles continues on the supplement Neuro Oncol Rev 2020 Oct;22(s4).

Contents


Central nervous system tumors


Gliomas


High-grade gliomas


Low-grade gliomas


Diffuse astrocytic and oligodendroglial tumors


Glioblastoma


Diffuse Midline Glioma


Embryonal tumors


Medulloblastoma


Tumors of the sellar region


Craniopharingioma



Central nervous system tumors


Cole AP, Hoffmeyer E, Chetty SL, Cruz-Cruz J, Hamrick F, Youssef O, Cheshier S, Mitra SS.
Microglia in the Brain Tumor Microenvironment.
Adv Exp Med Biol. 2020 Oct 30. 2020;1273:197-208. doi: 10.1007/978-3-030-49270-0_11. Book chapter. _
In this chapter, we summarize the current knowledge of how and where microglia are generated. We also discuss their functions during brain development, injury repair, and homeostasis. Moreover, we discuss the role of microglia in the tumor microenvironment of gliomas and highlight their therapeutic implications.




Karanam NK, Story MD.
An overview of potential novel mechanisms of action underlying Tumor Treating Fields-induced cancer cell death and their clinical implications.
Int J Radiat Biol. 2020 Oct 21. 2020:1-11. doi: 10.1080/09553002.2020.1837984. Review. _
TTFields are thought to kill tumor cells predominantly by disrupting mitosis; however it has been shown that TTFields increase efficacy of different classes of drugs, which directly target mitosis, replication stress and DNA damage pathways. ... Recent findings implicate TTFields’ role in different important pathways such as DNA damage response and replication stress, ER stress, membrane permeability, autophagy, and immune response. This review focuses on potentially novel mechanisms of TTFields anti-tumor action and their implications in completed and ongoing clinical trials and pre-clinical studies. Moreover, the review discusses advantages and strategies using chemotherapy agents and radiation therapy in combination with TTFields for future clinical use.




Mukasa A.
Genome Medicine for Brain Tumors: Current Status and Future Perspectives.
Neurol Med Chir (Tokyo). 2020 Oct 16. doi: 10.2176/nmc.ra.2020-0175. Review. _
As a result of rapid progress in genome medicine technologies, such as the evolution of DNA sequencing and the development of molecular targeted drugs, the era of precision cancer medi­cine has begun. … However, patients with brain tumors have not benefited much from genome medicine, even though gliomas contain many potential molecular targets, such as alterations in EGFR, IDH1/2, BRAF, and Histone H3K27. Targeted therapies for these molecules are currently under enthusiastic development; however, such attempts have not yet achieved remarkable success. To date, only a limited number of tar­geted drugs for brain tumors such as immune checkpoint, neurotrophic tyrosine receptor kinase (NTRK), and Bruton tyrosine kinase (BTK) inhibitors are available, and only in limited cases. Several obstacles remain in the development of drugs to treat brain tumors, including the diffi­culties in conducting clinical trials because of the relatively rare incidence and in drug delivery through the blood–brain barrier (BBB). Furthermore, general problems for numerous types of cancer, such as tumor heterogeneity, also exist for brain tumors.




Cooney T, Yeo KK, Kline C, Prados M, Haas-Kogan D, Chi S, Mueller S.
Neuro-Oncology Practice Clinical Debate: targeted therapy vs conventional chemotherapy in pediatric low-grade glioma.
Neurooncol Pract. 2019 Aug 13. 2020;7(1):4-10. doi: 10.1093/nop/npz033. Review. _

The treatment of children with low-grade glioma has evolved over the last several decades, beginning initially with focal radiotherapy, which has now been largely replaced by systemic treatment with conventional chemotherapy agents or more recently molecularly targeted therapeutics. … The groups from the University of California, San Francisco and Dana Farber Cancer Institute, moderated by Michael Prados, herein debate the merits of cytotoxic chemotherapy and targeted therapeutics as initial treatment strategies in pediatric low-grade glioma, a topic discussed daily in Tumor Boards across the United States and abroad.




Yahya N, Manan HA.
Neurocognitive impairment following proton therapy for paediatric brain tumour: a systematic review of post-therapy assessments.
Support Care Cancer. 2020 Oct 11. doi: 10.1007/s00520-020-05808-z. Review. _
Available evidence suggests that proton therapy causes less cognitive deficits compared with photon therapy. Children who underwent focal therapy with proton were consistently shown to have low risk of cognitive deficit suggesting the need for future studies to separate them from craniospinal irradiation . Evidence on the effect of dose distribution to cognition in proton therapy is yet to mature.




Zhang ZH, Lin MT, Chen L.
Editorial: Molecular Advances in Diagnosis and Treatment of CNS Tumors.
Front Oncol. 2020 Sep 25. 2020;10:590293. doi: 10.3389/fonc.2020.590293. Editorial. _
Management of CNS tumor patients has undergone a molecular revolution driven by the development of high throughput molecular techniques. Molecular testing has become an essential part for the optimal CNS tumor patient workup. At the current stage, a combination of FISH, copy number array, NGS panel and genome-wide methylation profiling can be used to detect molecular alterations in order to provide the best possible patient care. It is true that our ability of amassing molecular data currently surpasses our ability to utilize this information for treatment; however, it is clear that informative molecular biomarkers will guide future clinical trials and lead to the development of new therapeutic strategies.



Gliomas


Ding X, Yang L, Geng X, Zou Y, Wang Z, Li Y, Qi R, Wang W, Li J, Yu H.
CircRNAs as potential biomarkers for the clinicopathology and prognosis of glioma patients: a meta-analysis.
BMC Cancer. 2020 Oct 15. 2020;20(1):1005. doi: 10.1186/s12885-020-07446-4. Meta-analysis. _
An increasing number of studies have reported circular RNAs (circRNAs) as new potential biomarkers for the prognosis of gliomas. However, the overall prognostic value of circRNAs for glioma remains unclear. Therefore, this study is the first comprehensive evaluation of the clinicopathological and prognostic value of dysregulated circRNAs in the treatment of glioma patients.




Mondal I, Kulshreshtha R.
Potential of microRNA based diagnostics and therapeutics in glioma: a patent review.
Expert Opin Ther Pat. 2020 Oct 14. doi: 10.1080/13543776.2021.1837775. Review. _
MicroRNA-based anti-cancer research has been extensively carried out throughout the last decade and the results look promising. These molecules can be efficient biomarkers of glioma and used as therapeutic targets/agents. But, just like any other evolving medical technology, it also faces challenges for moving from the bench to the bedside. However, if correctly addressed, these problems can be overcome, and microRNA-based technologies can advance to be efficient tools for the treatment of glioma.




Wu G, Song X, Liu J, Li S, Gao W, Qiu M, Yang C, Ma Y, Chen Y.
Expression of CD44 and the survival in glioma: a meta-analysis.
Biosci Rep. 2020 Mar 31. 2020;40(4):BSR20200520. doi: 10.1042/BSR20200520. Meta-analysis. _
Results showed that increased CD44 expression in tumor predicted poor OS in glioma patients. Subgroup analyses showed that higher tumor CD44 expression significantly predicted poor OS in patients with WHO stages II-III glioma, but not in patients with glioblastoma.



High-grade gliomas



Saeed H, Tseng YD, Lo SS.
Narrative review of palliative hypofractionated radiotherapy for high grade glioma.
Ann Palliat Med. 2020 Sep 22. doi: 10.21037/apm-20-1246. Review. _
Here, we aim to review the palliative management options available for HGG patients with an emphasis on the role of radiotherapy.



Diffuse astrocytic and oligodendroglial tumors



Glioblastoma



Gilbar PJ, Pokharel K, Mangos HM.
Temozolomide-induced aplastic anaemia: Case report and review of the literature.
J Oncol Pharm Pract. 2020 Oct 22. doi: 10.1177/1078155220967087. Case report and review. _
Whilst most cases of aplastic anaemia are idiopathic, a careful drug, occupational exposure and family history should be obtained, as acquired aplastic anaemia may result from viruses, chemical exposure, radiation and medications. Temozolomide-induced aplastic anaemia is well documented, though only 12 cases have been described in detail. Other potential causes were eliminated in our patient. Physicians should be aware of this rare and potentially fatal toxicity when prescribing. Frequent blood tests should be performed, during and following Temozolomide treatment, to enable early detection.




Khandwala K, Mubarak F, Minhas K.
The many faces of glioblastoma: Pictorial review of atypical imaging features.
Neuroradiol J. 2020 Oct 20. doi: 10.1177/1971400920965970. Review. _
In this pictorial essay, we present cases of pathologically confirmed GBM that illustrate unusual locations and atypical features on neuroimaging, and review the relevant literature. Even innocuous-looking foci, cystic lesions, meningeal-based pathology, intraventricular and infratentorial masses, multifocal/multicentric lesions and spinal cord abnormalities may represent GBM. We aim to highlight the atypical characteristics of glioblastoma, clarify their importance and list the potential mimickers.




Marchesini N, Bernasconi R, Ghimenton C, Pinna G.
Glioblastoma multiforme with oculomotor nerve involvement: case report and literature review.
Br J Neurosurg. 2020 Oct 23. 2020;1-5. doi: 10.1080/02688697.2020.1837732. Case report and review. _
We report the case of a 69-year-old man who presented with an isolated left oculomotor nerve palsy. He was found to have a left temporal GBM extended to the frontal lobe. Diagnostics and intraoperative and pathological findings clearly demonstrated a massive infiltration of the cisternal portion of the left oculomotor nerve. We suppose this could be the first case of direct oculomotor nerve invasion by exophytic spread of a supratentorial GBM or by subarachnoid seeding from a temporal tumor. Less probably, it could be the first case of an oculomotor nerve GBM with a temporal lobe invasion.




Qin C, Long W, Zhang C, Xie Y, Wu C, Li Y, Xiao Q, Ji N, Liu Q.
Multidisciplinary Therapy Managed Recurrent Glioblastoma in a BRAF-V600E Mutant Pregnant Female: A Case Report and Review of the Literature.
Front Oncol. 2020 Sep 29. 2020;10:522816. doi: 10.3389/fonc.2020.522816. Case report and review. _

We present a pregnant female at 20 weeks gestation diagnosed with GBM. Surgical resection was initially performed without adjuvant therapy, and the tumor recurred de novo 2 months later. A secondary craniotomy and cesarean section were performed simultaneously at 32 weeks gestation, both the patient and infant were survived. She was subsequently treated with traditional chemo-radiotherapy. No other identified genetic alterations indicating an optimistic prognosis were detected except for BRAF V600E mutation. Thus, the BRAF inhibitor was placed on her with achieving a good clinical outcome of more than 2-year survival without recurrence.




Rogers LR, Ostrom QT, Schroer J, Vengoechea J, Li L, Gerson S, Nock CJ, Machtay M, Selman W, Lo S, Sloan AE, Barnholtz-Sloan JS.
Association of metabolic syndrome with glioblastoma: a retrospective cohort study and review.
Neurooncol Pract. 2020 Mar 31. 2020;7(5):541-548. doi: 10.1093/nop/npaa011. Retrospective analysis and review. _
We identified the metabolic syndrome in at a slightly higher frequency in patients diagnosed with glioblastoma as compared to the general population. In addition, metabolic syndrome with each of its individual components is associated with an overall worse prognosis in patients receiving the standard schedule of radiation and temozolomide after adjustment for age.




Stylli SS.
Novel Treatment Strategies for Glioblastoma.
Cancers (Basel). 2020 Oct 8. 2020;12(10):2883. doi: 10.3390/cancers12102883. Editorial. _
Current treatments are far from satisfactory, and studies investigating acquired/inherent resistance to current therapies, restricted drug delivery, inter/intra-tumoral heterogeneity, drug repurposing and a tumor immune-evasive environment have been the focus of intense research over recent years. While the clinical advancement of GBM therapeutics has seen limited progression compared to other cancers, developments in novel treatment strategies that are being investigated are displaying encouraging signs for combating this disease. This aim of this editorial is to provide a brief overview of a select number of these novel therapeutic approaches.




Wang H, Zhou H, Xu J, Lu Y, Ji X, Yao Y, Chao H, Zhang J, Zhang X, Yao S, Wu Y, Wan J.
Different T-cell subsets in glioblastoma multiforme and targeted immunotherapy.
Cancer Lett. 2020 Oct 3. 2020;496:134-143. doi: 10.1016/j.canlet.2020.09.028. Review. _
Immunotherapy has attracted increasing attention in recent years. As the pioneer and the main effector cells of immunotherapy, T cells play a key role in tumor immunotherapy. However, the T cells in GBM microenvironment are inhibited by the highly immunosuppressive environment of GBM, posing huge challenges to T cell-based GBM immunotherapy. This review summarizes the effects of the GBM microenvironment on the infiltration and function of different T-cell subsets and the possible strategies to overcome immunosuppression, and thus enhance the effectiveness of GBM immunotherapy.




Wykes V, Zisakis A, Irimia M, Ughratdar I, Sawlani V, Watts C.
Importance and Evidence of Extent of Resection in Glioblastoma.
J Neurol Surg A Cent Eur Neurosurg. 2020 Oct 13. doi: 10.1055/s-0040-1701635. Review. _
Maximal safe resection is an essential part of the multidisciplinary care of patients with glioblastoma. A growing body of data shows that gross total resection is an independent prognostic factor associated with improved clinical outcome.
Recent developments in neurosurgical techniques and technologies focused on maximizing extent of resection and safety are discussed.




Xiao ZZ, Wang ZF, Lan T, Huang WH, Zhao YH, Ma C, Li ZQ.
Carmustine as a Supplementary Therapeutic Option for Glioblastoma: A Systematic Review and Meta-Analysis.
Front Neurol. 2020 Sep 17. 2020;11:1036. doi: 10.3389/fneur.2020.01036. Review and Meta-Analysis. _
Carmustine implantation in resection cavity provides survival benefit for GBM patients, and it may be a promising supplement to standard therapeutic protocol by offering a bridge between surgical resection and onset of TMZ therapy.




Yang C, Wen HB, Zhao YH, Huang WH, Wang ZF, Li ZQ.
Systemic Inflammatory Indicators as Prognosticators in Glioblastoma Patients: A Comprehensive Meta-Analysis.
Front Neurol. 2020 Oct 7. 2020;11:580101. doi: 10.3389/fneur.2020.580101. Meta-Analysis. _
The neutrophil-to-lymphocyte ratio and the absolute neutrophil and platelet counts may be valuable and convenient peripheral inflammatory markers to evaluate the prognosis of GBM patients. Further prospective studies are needed to verify its reliability.



Diffuse midline glioma



Park J, Yea JW, Park JW.
Hypofractionated radiotherapy versus conventional radiotherapy for diffuse intrinsic pontine glioma: A systematic review and meta-analysis.
Medicine (Baltimore). 2020 Oct 16. 2020;99(42):e22721. doi: 10.1097/MD.0000000000022721. Review and meta-analysis. _
The results of this meta-analysis suggest that CFRT and HFRT provide similar survival outcomes for patients with DIPG.



Embryonal tumors



Medulloblastoma



Elarjani T, Altewerki M, Alsuwaidan A, Alhuthayl M, Hassounah M.
Molecular Association of Medulloblastoma and Sarcoidosis: Case Report and Review of the Literature.
World Neurosurg. 2020 Sep 30. 2020;145:290-294. doi: 10.1016/j.wneu.2020.09.135. Case report and review. _
The exceedingly rare coexistence of adult MB and sarcoidosis may have a causal relationship based on specific common molecules. Leukotrienes, stimulation of astrocytes and Purkinje neurons, and the sonic hedgehog signaling pathway can be considered. Further genetic and molecular studies are merited.




Troncon I, Guerriero A, Rossi S, Ronzon M, Padovan M, Mario C, Zanatta L, Toffolatti L, Marton E, Lombardi G, Tos APD, Canova G.
Multifocal Medulloblastoma in an Adult Patient: Description of a Rare Presentation and Review of the Literature.
Case Rep Pathol. 2020 Sep 11. 2020;2020:4502878. doi: 10.1155/2020/4502878. Case report and review. _
Adult medulloblastoma is extremely rare. Important differences exist between adult medulloblastoma and medulloblastoma arising in children and infants. Such differences are in location, distribution of histological variants and of molecular subgroups, survival rates, and therapeutic options. An extensive morphological and molecular characterization of such rare tumors is necessary to choice the best-tailored therapy.



Tumors of the sellar region



Craniopharingioma



Nuijts MA, Veldhuis N, Stegeman I, van Santen HM, Porro GL, Imhof SM, Schouten-van Meeteren AYN.
Visual functions in children with craniopharyngioma at diagnosis: A systematic review.
PLoS One. 2020 Oct 1. 2020;15(10):e0240016. doi: 10.1371/journal.pone.0240016. Review. _
Childhood craniopharyngioma is a rare and slow growing brain tumour, often located in the sellar and suprasellar region. It commonly manifests with visual impairment, increased intracranial pressure and hypothalamic and/or pituitary deficiencies. Visual impairment in childhood adversely affects a child’s daily functioning and quality of life. We systematically reviewed the literature to provide an extensive overview of the visual function in children with craniopharyngioma at diagnosis in order to estimate the diversity, magnitude and relevance of the problem of visual impairment.



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