Experimental Treatment Approaches

Chapter 4 - Treatment Strategies for Anaplastic Astrocytoma and Glioblastoma

Various novel antiangiogenic agents targeting Vascular endothelial growth factor (VEGF)-dependent and VEGF-independent pathways are being tested, mostly in recurrent glioblastoma.

Epidermal growth factor receptor (EGFR), phosphatidyl-inositol (PI)-3 kinase, mechanistic target of rapamycin (mTOR) and c-MET are typical pathways for targeted therapy in glioblastoma.

There is increasing interest in exploiting aberrant metabolic pathways for therapeutic purposes.

Rindopepimut is a vaccine targeting a specific deletion mutation of EGFR referred to as vIII or delta-EGFR.

ICT-107 is a cocktail of six peptides used for autologous dendritic cell (DC) vaccination.

Checkpoint inhibitors, e.g. antibodies to cytotoxic T lymphocyte-associated antigen (CTLA)-4, or programmed death (PD)-1, or PD-1 Ligand, are being explored as novel treatments.

Experimental Treatment Approaches Figure 3

Courtesy R. Stupp, Zurich, Switzerland

Tumour-treating fields are a novel treatment approach based on electrical fields that may prolong survival in newly diagnosed glioblastoma.

Oncolytic viruses continue to be explored and may induce therapeutic inflammation linked to improved outcome.

The role of cytomegalovirus (CMV) in the aetiology or as a target in glioblastoma remains controversial.

Revision Questions

  1. What are the main pathways of intervention for targeted therapy?
  2. What are the main approaches of immunotherapy for anaplastic astrocytoma and glioblastoma?
  3. What precisely is EGFRvIII?

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Last update: 18 September 2017