Therapy for Gliomas

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (1 May 2023) | Viewed by 8927

Special Issue Editors


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Guest Editor
Department of Oncology, Veneto Institute of Oncology-IRCCS, Padua, Italy
Interests: brain tumors; targeted therapy; quality of life; brain metastases
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Guest Editor
Department of Neurosurgery, “Santa Chiara” Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
Interests: brain tumors; neurosurgery; brain metastases

Special Issue Information

Dear Colleagues,

Gliomas represent frequent and aggressive malignant primary brain tumors in adults and pediatric patients. Despite growing knowledge of the molecular changes responsible for tumor development, these tumors remain neoplastic with unmet medical needs. So, it is very important to characterize gliomas with advanced imaging such as MR spectroscopy and positron emission tomography to plan neurosurgery and subsequent treatments and analyze molecular alterations. It is noteworthy that molecular alterations could represent important prognostic factors and specific targets for precision medicine trials in these neoplasms. In the last few years, many translational and clinical studies have been performed, and new treatments with radiotherapy, new neurosurgical approaches, targeted therapy, immunotherapy, and combination treatments are ongoing.

This Special Issue will cover all aspects of gliomas, including original research on advanced imaging, molecular characteristics, current and experimental treatment options, supportive care, neurocognitive functions, and quality of life. Expert opinions, systematic reviews, and meta-analyses are also welcome. We look forward to receiving your contributions.

Dr. Giuseppe Lombardi
Dr. Silvio Sarubbo
Guest Editors

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Published Papers (2 papers)

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Research

15 pages, 3560 KiB  
Article
Important Requirements for Desorption/Ionization Mass Spectrometric Measurements of Temozolomide-Induced 2′-Deoxyguanosine Methylations in DNA
by Margaux Fresnais, Ina Jung, Uli B. Klein, Aubry K. Miller, Sevin Turcan, Walter E. Haefeli, Jürgen Burhenne and Rémi Longuespée
Cancers 2023, 15(3), 716; https://doi.org/10.3390/cancers15030716 - 24 Jan 2023
Cited by 1 | Viewed by 6472
Abstract
In clinical pharmacology, drug quantification is mainly performed from the circulation for pharmacokinetic purposes. Finely monitoring the chemical effect of drugs at their chemical sites of action for pharmacodynamics would have a major impact in several contexts of personalized medicine. Monitoring appropriate drug [...] Read more.
In clinical pharmacology, drug quantification is mainly performed from the circulation for pharmacokinetic purposes. Finely monitoring the chemical effect of drugs at their chemical sites of action for pharmacodynamics would have a major impact in several contexts of personalized medicine. Monitoring appropriate drug exposure is particularly challenging for alkylating drugs such as temozolomide (TMZ) because there is no flow equilibrium that would allow reliable conclusions to be drawn about the alkylation of the target site from plasma concentrations. During the treatment of glioblastoma, it appears, therefore, promising to directly monitor the alkylating effect of TMZ rather than plasma exposure, ideally at the site of action. Mass spectrometry (MS) is a method of choice for the quantification of methylated guanines and, more specifically, of O6-methylguanines as a marker of TMZ exposure at the site of action. Depending on the chosen strategy to analyze modified purines and 2′-deoxynucleosides, the analysis of methylated guanines and 2′-deoxyguanosines is prone to important artefacts due to the overlap between masses of (i) guanines from DNA and RNA, and (ii) different methylated species of guanines. Therefore, the specific analysis of O6-methyl-2′deoxyguanosine, which is the product of the TMZ effect, is highly challenging. In this work, we report observations from matrix-assisted laser desorption/ionization (MALDI), and desorption electrospray ionization (DESI) MS analyses. These allow for the construction of a decision tree to initiate studies using desorption/ionization MS for the analysis of 2′-deoxyguanosine methylations induced by TMZ. Full article
(This article belongs to the Special Issue Therapy for Gliomas)
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18 pages, 1611 KiB  
Article
Safety of Inhomogeneous Dose Distribution IMRT for High-Grade Glioma Reirradiation: A Prospective Phase I/II Trial (GLIORAD TRIAL)
by Patrizia Ciammella, Salvatore Cozzi, Andrea Botti, Lucia Giaccherini, Roberto Sghedoni, Matteo Orlandi, Manuela Napoli, Rosario Pascarella, Anna Pisanello, Marco Russo, Francesco Cavallieri, Maria Paola Ruggieri, Silvio Cavuto, Luisa Savoldi, Cinzia Iotti and Mauro Iori
Cancers 2022, 14(19), 4604; https://doi.org/10.3390/cancers14194604 - 22 Sep 2022
Cited by 5 | Viewed by 1848
Abstract
Glioblastoma multiforme (GBM) is the most aggressive astrocytic primary brain tumor, and concurrent temozolomide (TMZ) and radiotherapy (RT) followed by maintenance of adjuvant TMZ is the current standard of care. Despite advances in imaging techniques and multi-modal treatment options, the median overall survival [...] Read more.
Glioblastoma multiforme (GBM) is the most aggressive astrocytic primary brain tumor, and concurrent temozolomide (TMZ) and radiotherapy (RT) followed by maintenance of adjuvant TMZ is the current standard of care. Despite advances in imaging techniques and multi-modal treatment options, the median overall survival (OS) remains poor. As an alternative to surgery, re-irradiation (re-RT) can be a therapeutic option in recurrent GBM. Re-irradiation for brain tumors is increasingly used today, and several studies have demonstrated its feasibility. Besides differing techniques, the published data include a wide range of doses, emphasizing that no standard approach exists. The current study aimed to investigate the safety of moderate–high-voxel-based dose escalation in recurrent GBM. From 2016 to 2019, 12 patients met the inclusion criteria and were enrolled in this prospective single-center study. Retreatment consisted of re-irradiation with a total dose of 30 Gy (up to 50 Gy) over 5 days using the IMRT (arc VMAT) technique. A dose painting by numbers (DPBN)/dose escalation plan were performed, and a continuous relation between the voxel intensity of the functional image set and the risk of recurrence in that voxel were used to define target and dose distribution. Re-irradiation was well tolerated in all treated patients. No toxicities greater than G3 were recorded; only one patient had severe G3 acute toxicity, characterized by muscle weakness and fatigue. Median overall survival (OS2) and progression-free survival (PFS2) from the time of re-irradiation were 10.4 months and 5.7 months, respectively; 3-, 6-, and 12-month OS2 were 92%, 75%, and 42%, respectively; and 3-, 6-, and 12-month PFS2 were 83%, 42%, and 8%, respectively. Our work demonstrated a tolerable tolerance profile of this approach, and the future prospective phase II study will analyze the efficacy in terms of PFS and OS. Full article
(This article belongs to the Special Issue Therapy for Gliomas)
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