Neurotherapeutics

, Volume 14, Issue 2, pp 284–297 | Cite as

Glioma Subclassifications and Their Clinical Significance

  • Ricky Chen
  • Matthew Smith-Cohn
  • Adam L. Cohen
  • Howard Colman
Review

Abstract

The impact of targeted therapies in glioma has been modest. All the therapies that have demonstrated a significant survival benefit for gliomas in Phase III trials, including radiation, chemotherapy (temozolomide and PCV [procarbazine, lomustine, vincristine]), and tumor-treating fields, are based on nonspecific targeting of proliferating cells. Recent advances in the molecular understanding of gliomas suggest some potential reasons for the failure of more targeted therapies in gliomas. Specifically, the histologic-based glioma classification is composed of multiple different molecular subtypes with distinct biology, natural history, and prognosis. As a result of these insights, the diagnosis and classification of gliomas have recently been updated by the World Health Organization. However, these changes and other novel observations regarding glioma biomarkers and subtypes highlight several clinical challenges. First, the field is faced with the difficulty of reinterpreting the results of prior studies and retrospective data using the new classifications to clarify prognostic assessments and treatment recommendations for patients. Second, the new classifications and insights require rethinking the design and stratification of future clinical trials. Last, these observations provide the essential framework for the development and testing of new specific targeted therapies for particular glioma subtypes. This review aims to summarize the current literature regarding glioma subclassifications and their clinical relevance in this evolving field.

Keywords

Glioma Ependymoma Targeted therapy IDH mutation MGMT methylation TERT promoter EGFR BRAF 1p/19q co-deletion 2HG MR spectroscopy Vaccine therapy 

Supplementary material

13311_2017_519_MOESM1_ESM.pdf (1.2 mb)
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Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc. 2017

Authors and Affiliations

  • Ricky Chen
    • 1
  • Matthew Smith-Cohn
    • 1
  • Adam L. Cohen
    • 2
  • Howard Colman
    • 3
  1. 1.Department of Neurology, Clinical Neurosciences CenterUniversity of UtahSalt Lake CityUSA
  2. 2.Division of Oncology, Department of Internal Medicine, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUSA
  3. 3.Department of Neurosurgery, Huntsman Cancer Institute and Clinical Neuroscience CenterUniversity of UtahSalt Lake CityUSA

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