Neurosurgical Review

, Volume 31, Issue 2, pp 141–155

Molecular strategies for the treatment of malignant glioma—genes, viruses, and vaccines

Authors

  • Lee A. Selznick
    • Division of NeurosurgeryDuke University Medical Center
  • Mohammed F. Shamji
    • Division of NeurosurgeryThe Ottawa Hospital
    • Department of Biomedical EngineeringDuke University
  • Peter Fecci
    • Duke University School of Medicine
  • Matthias Gromeier
    • Division of NeurosurgeryDuke University Medical Center
  • Allan H. Friedman
    • Division of NeurosurgeryDuke University Medical Center
    • Division of NeurosurgeryDuke University Medical Center
Review

DOI: 10.1007/s10143-008-0121-0

Cite this article as:
Selznick, L.A., Shamji, M.F., Fecci, P. et al. Neurosurg Rev (2008) 31: 141. doi:10.1007/s10143-008-0121-0

Abstract

The standard treatment paradigm of surgery, radiation, and chemotherapy for malignant gliomas has only a modest effect on survival. It is well emphasized in the literature that despite aggressive multimodal therapy, most patients survive approximately 1 year after diagnosis, and less than 10% survive beyond 2 years. This dismal prognosis provides the impetus for ongoing investigations in search of improved therapeutics. Standard multimodal therapy has largely reached a plateau in terms of effectiveness, and there is now a growing body of literature on novel molecular approaches for the treatment of malignant gliomas. Gene therapy, oncolytic virotherapy, and immunotherapy are the major investigational approaches that have demonstrated promise in preclinical and early clinical studies. These new molecular technologies each have distinct advantages and limitations, and none has yet demonstrated a significant survival benefit in a phase II or III clinical trial. Molecular approaches may not lead to the discovery of a “magic bullet” for these aggressive tumors, but they may ultimately prove synergistic with more conventional approaches and lead to a broadening of the multimodal approach that is the current standard of care. This review will discuss the scientific background, therapeutic potential, and clinical limitations of these novel strategies with a focus on those that have made it to clinical trials.

Keywords

GliomaGene therapyVirotherapyOncolytic virusesImmunotherapy

Copyright information

© Springer-Verlag 2008