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Cited by 812Glioma Diagnosis and TreatmentRadiomics and Machine Learning in Medical ImagingAcute Myeloid Leukemia Research

Glioma Subclassifications and Their Clinical Significance

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Chen, Ricky, Smith-Cohn, Matthew, Cohen, Adam L., Colman, Howard·2017·Neurotherapeutics
DOI 10.1007/s13311-017-0519-xPMC PMC5398991
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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.

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  • Prognosis of glioma patients cannot be simply determined by pathological grade; molecular features such as PTEN deletion, EGFR amplification, MYCN amplification, and MGMT methylation play an important role.

    “At present, the prognosis of glioma patients cannot be simply determined by pathological grade. Molecular features such as PTEN deletion, EGFR amplification, MYCN amplification, MGMT methylation, etc. play an important role 22.”

    From miR-21-5p Inhibits the Proliferation, Migration, and Invasion of Glioma by Targeting S100A10 (2023) · cites this paper as [22]

    The Comprehensive Molecular Profiling of Infiltrative Gliomas section reports different prognoses for molecular groups even when their histologic grades overlap, and the MGMT Promoter Methylation section identifies MGMT methylation as a prognostic marker in GBM. The Therapeutics and Clinical Trial Planning section discusses EGFR amplification as a marker for treatment studies, but identifies EGFRvIII deletion—not amplification—as a negative prognostic indicator. The retrieved passages do not establish prognostic roles for PTEN deletion or MYCN amplification (pages unavailable). (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Chen, R., Smith-Cohn, M., Cohen, A. L., & Colman, H.
Affiliations
University of Utah (US)
Corresponding author
Colman, Howard
ORCID
Venue
Neurotherapeutics
Publisher
Elsevier BV
Published
2017-04
Volume
14
Issue
2
Pages
284-297
ISSN
1878-7479 (ISSN-L)
DOI
10.1007/s13311-017-0519-x
PMC
PMC5398991
OpenAlex
W2592264367
Cited by
812
References
13
Citations by year
2026: 55 · 2025: 104 · 2024: 142 · 2023: 111 · 2022: 142 · 2021: 140 · 2020: 86 · 2019: 16 · 2018: 7 · 2017: 9
FWCI
4.56
Type
journal article
Language
en
Open access
Licence
Locations
  • Neurotherapeutics (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
Keywords
glioma, molecular subtypes, histological classification, WHO classification, glioma biomarkers, targeted therapy, prognosis, clinical trial stratification, temozolomide, procarbazine, lomustine, and vincristine, tumor treating fields
MeSH terms
Brain Neoplasms, Glioma, Humans, Mutation, World Health Organization, Gene Expression, Gene Deletion, Molecular Targeted Therapy

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