Conventional chemotherapy and perspectives for molecular-based oncological treatment in pediatric hemispheric low-grade gliomas

• Published in: Child's nervous system 2016-10, Vol.32 (10), p.1939-1945
• Main Authors: Fernández, María Baro, Alonso, Vanesa Pérez
• Format: Article
• Language: English
• Subjects: Antineoplastic Agents - therapeutic use; Brain Neoplasms - drug therapy; Brain Neoplasms - genetics; Combined Modality Therapy; Disease-Free Survival; Glioma - drug therapy; Glioma - genetics; Humans; Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Pediatrics; ras Proteins - genetics; ras Proteins - metabolism; Signal Transduction - drug effects; Signal Transduction - genetics; Special Annual Issue; TOR Serine-Threonine Kinases - genetics; TOR Serine-Threonine Kinases - metabolism
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-016-3132-0

Introduction Pediatric low-grade gliomas (PLGG) are the most common primary central nervous system tumor in children. Patients in whom gross total resection can be achieved have an excellent overall (OS) and event-free survival (EFS) and do not require adjuvant therapy. However, children with unresectable tumors often experience multiple progressions and require additional treatment. Conventional chemotherapy Radiotherapy results in long-term tumor control, but it is associated with significant toxicity, making chemotherapy the preferred therapeutic option. Several chemotherapy combinations have been found to be successful in PLGG, but 5-year EFS has been below 60 % with most of them. Molecular-based treatment Recent molecular advances have led to a better understanding of the molecular pathways involved in the biology of LGG, allowing the development of promising tumor-specific, molecularly targeted therapies.