Epigenetic pathways and glioblastoma treatment.

Epigenetic pathways and glioblastoma treatment.
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DOI:
10.4161/epi.25440
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发表时间:
2013-08
期刊:
影响因子:
3.7
通讯作者:
Ayad NG
Ayad NG
中科院分区:
生物学3区
文献类型:
--
作者:
Clarke J;Penas C;Pastori C;Komotar RJ;Bregy A;Shah AH;Wahlestedt C;Ayad NG

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多形性胶质母细胞瘤(GBM)是最常见的恶性成人脑肿瘤。标准GBM治疗包括最大安全手术切除联合放疗和辅助替莫唑胺(TMZ)化疗。令人担忧的是,患者5年生存率低于10%。这部分是由于肿瘤的侵袭性行为以及由此导致的无法切除超过98%的一些肿瘤。事实上,这种治疗后的复发可能是不可避免的,即使在病例中实现了总切除。癌症基因组图谱(TCGA)研究网络对GBM肿瘤进行了全基因组测序,发现GBM复发与表观遗传机制和途径有关。这些途径的核心是表观遗传酶,它们最近成为多种癌症(包括GBM)的可能新药靶点。在这里,我们审查GBM治疗,并提供一个系统的方法来确定GBM肿瘤进展的表观遗传驱动程序的基础上,假定GBM细胞的起源时间建模。我们还讨论了在定义控制GBM起始和复发的表观遗传机制方面的进展,以及与靶向表观遗传酶用于GBM治疗相关的药物发现考虑因素。
Glioblastoma multiforme (GBM) is the most common malignant adult brain tumor. Standard GBM treatment includes maximal safe surgical resection with combination radiotherapy and adjuvant temozolomide (TMZ) chemotherapy. Alarmingly, patient survival at five-years is below 10%. This is in part due to the invasive behavior of the tumor and the resulting inability to resect greater than 98% of some tumors. In fact, recurrence after such treatment may be inevitable, even in cases where gross total resection is achieved. The Cancer Genome Atlas (TCGA) research network performed whole genome sequencing of GBM tumors and found that GBM recurrence is linked to epigenetic mechanisms and pathways. Central to these pathways are epigenetic enzymes, which have recently emerged as possible new drug targets for multiple cancers, including GBM. Here we review GBM treatment, and provide a systems approach to identifying epigenetic drivers of GBM tumor progression based on temporal modeling of putative GBM cells of origin. We also discuss advances in defining epigenetic mechanisms controlling GBM initiation and recurrence and the drug discovery considerations associated with targeting epigenetic enzymes for GBM treatment.
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