Herausforderungen in der Diagnose und Behandlung von Rezidivgliomen View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-03

AUTHORS

Markus Weiler, Lorna Whyte, Sibylle Hodecker, Wolfgang Wick

ABSTRACT

Trotz ermutigender Daten in der Primärtherapie von Glioblastompatienten mit Methylierung des Promotors der O6-Methylguanyl-Methyltransferase (MGMT) ist neben der weiteren Optimierung dieser Therapie vor allem die Entwicklung von effektiven Rezidivtherapien vordringlich. In Analogie zu präklinischen Ergebnissen wurde vermutet, dass das Verständnis molekularer prognostischer und insbesondere für eine spezifische Therapie prädiktiver Parameter eine verbesserte Patientenselektion vor Therapie- oder Studienbeginn ermögliche und damit den unselektiven Einsatz selektiv wirkender Therapien verhindere. Aktuell verfügbare molekulare Parameter sind allerdings vor allem prognostisch und nicht prädiktiv. Aktuelle multinationale Studienkonzepte bei malignen Gliomen schließen dennoch erstmals Patienten nach vorhergehender molekularer Untersuchung des 1p/19q-Status oder der Methylierung des MGMT-Promotors ein. Eine Herausforderung für neue Studien ist neben der unmittelbaren Verbesserung der Therapie die Etablierung molekularer prädiktiver Signaturen. Aufgrund der drängenden klinischen Situation und der biologischen Spezifika von hirneigenen Tumoren werden aktuell auch neuartige Konzepte wie die Entwicklung zellulärer Vehikel für die Therapie oder die Verwendung von lentiviral tranduziertem, alkylanzienresistentem Knochenmark untersucht. More... »

PAGES

23-29

Journal

TITLE

Onkopipeline

ISSUE

1

VOLUME

2

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s15035-009-0143-2

DOI

http://dx.doi.org/10.1007/s15035-009-0143-2

DIMENSIONS

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50 schema:description Trotz ermutigender Daten in der Primärtherapie von Glioblastompatienten mit Methylierung des Promotors der O6-Methylguanyl-Methyltransferase (MGMT) ist neben der weiteren Optimierung dieser Therapie vor allem die Entwicklung von effektiven Rezidivtherapien vordringlich. In Analogie zu präklinischen Ergebnissen wurde vermutet, dass das Verständnis molekularer prognostischer und insbesondere für eine spezifische Therapie prädiktiver Parameter eine verbesserte Patientenselektion vor Therapie- oder Studienbeginn ermögliche und damit den unselektiven Einsatz selektiv wirkender Therapien verhindere. Aktuell verfügbare molekulare Parameter sind allerdings vor allem prognostisch und nicht prädiktiv. Aktuelle multinationale Studienkonzepte bei malignen Gliomen schließen dennoch erstmals Patienten nach vorhergehender molekularer Untersuchung des 1p/19q-Status oder der Methylierung des MGMT-Promotors ein. Eine Herausforderung für neue Studien ist neben der unmittelbaren Verbesserung der Therapie die Etablierung molekularer prädiktiver Signaturen. Aufgrund der drängenden klinischen Situation und der biologischen Spezifika von hirneigenen Tumoren werden aktuell auch neuartige Konzepte wie die Entwicklung zellulärer Vehikel für die Therapie oder die Verwendung von lentiviral tranduziertem, alkylanzienresistentem Knochenmark untersucht.
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