Glioblastoma multiforme

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Glioblastoma multiforme sive Glioblastoma[1] est species cancri cerebri, qui haud sanabilis est. Nam quinque annos post morbum inventum, solum 2 centesimae hominum hoc cancro laborantium supersunt.[2] Causae huius morbi adhuc ignotae sunt.

Imago glioblastomatis cum falcem cerebri amota propter diffusionem tumorem.

Tractatio difficile restat, in parte diversitate microcircumiectorum immunologicorum cancri[3]. Adhuc therapiae adversus cancri angiogenesem ineffectivae videbantur[4].

PathophysiologiaRecensere

In morbi cursu cellulae gliomata numero crescunt. Microcircumiectorum planitie diversitas insolita inter cellulas neoplasticas et non neoplasticas emergit. Abundissime sunt cellulae generis tumori associatorum macrophagocytorum (TAM), ergo cellulae systematis immunitatis innati, quae 40% massa cancri constituunt[5].

SymptomataRecensere

Generalia indefinitivaque symptomata sunt convulsiones novae vel adhuc incognitae, capitis dolor, nausea, vomitus, memoriae spoliatio, ac alia symptomata neurologica circumscripta[6], quamquam spectrum symptomatum de tumoris loco pendat; per haec symptomata se attollere aut celerrime queant, aut longe occultare.

Classificatio glioblastomatumRecensere

Classificatio ordinis mundi sanitarii (WHO) anni 2016 notat:

  • Glioblastomata IDH1 mutanda
    • Glioblastoma cellularum gigantium
    • Gliosarcoma
    • Glioblastoma epitheloidum
  • Glioblastoma IDH1, typi ferocis
  • Glioblastoma non alibi specificatum

Comparatio classificationis 2016 cum veta 2017 criteria genetica addita esse ostendit: IDH mutandum et typum ferocem[7].

TractatioRecensere

Adhuc sanatio glioblastomatis restat difficilis et estimatur tumorem recursurum esse[8]. Therapia per resectionem neurochirurgicam, radiotherapiam, chemotherapiam, et medicamentum temozolomidi fit.

Formae tractationis adhuc vel non generaliter probataeRecensere

In scientia hodierna medica novas tractationis formas investigantur[9] ut, verbi gratia, inhibitores receptorii EphA3, inhibitores EGFR (includens anticorpora monoclonalia), inhibitores VEGF.

Inhibitores VEGFRecensere

Glioblastomatibus multiformibus permulta vasa sanguinea sunt, ergo inhibitionem angiogenesis (generationis novorum vasorum sanguineorum) investigabatur. In angiogenesi factor crescentis endothelialis vascularis (VEGF) velut receptorium suum, receptorium VEGF (VEGFR), momenta habent. Adhuc tamen numquam strategia contra angiogenesem incrementum tumoris inhibere potuit. Effectus inhibitoris kinasum tyrosini Regorafenib incerti restant[10].

Interleukin 12Recensere

Interleukinum 12 (IL-12) est cytokinum cum effectibus contra cancrum. Nuper CHIOCCA et al. textui gliobastomatis genum IL-12 generantem applicaverunt[11].

NotaeRecensere

  1. "Glioblastoma and Malignant Astrocytoma". American Brain Tumour Association (ABTA) 
  2. Bleeker, Fonnet E.; Molenaar, Remco J.; Leenstra, Sieger (2012). "Recent advances in the molecular understanding of glioblastoma". Journal of Neuro-Oncology 108 (1): 11–27 
  3. De Leo A., Ugolini A., Veglia F. (Dec 2020). "Myeloid Cells in Glioblastoma Microenvironment". Cells 10 (1): 18 
  4. Ameratunga M., Pavlakis N., et al. (Nov 2018). "Anti-angiogenic therapy for high-grade glioma". The Cochrane database of systematic reviews 11 (11): CD008218 
  5. Buonfiglioli A., Hambardzumyan D. (Mar 2021). "Macrophages and microglia: the cerberus of glioblastoma". Acta neuropathologica communications 9 (1): 54 
  6. Alifieris C., Trafalis D. T. (Aug 2015). "Glioblastoma multiforme: Pathogenesis and Treatment". Pharmacology & Treatment 152 (63-82) 
  7. Komori T. (2017). "The 2016 WHO Classification of Tumours of the Central Nervous System: The Major Points of Revision". Neurologia medico-chirurgica 57 (7): 301-11 
  8. Gallego O. (Aug 2015). "Nonsurgical treatment of recurrent glioblastoma". Current oncology 22 (4): e273-81 
  9. Taylor O. G., Brzozowski J. S., Skelding K. A. (Sep 2019). "Glioblastoma Multiforme: An Overview of Emerging Therapeutic Targets". Frontiers in oncology 9: 963 .
  10. Lombardi G., De Salvo G. L., Brandes A. A., Eoli M., Rudà R., Faedi M., Lolli I., Pace A., et al. (Ian 2019). "Regorafenib compared with lomustine in patients with relapsed glioblastoma (REGOMA): a multicentre, open-label, randomised, controlled, phase 2 Trial". Lancet oncology 20 (1): 110-9 
  11. Chiocca E. A., Yu J. S., Lukas R. V., Solomon I. H., Ligon K. L., Nakashima H., Triggs D. A., Reardon D. A., Wen P. (Aug 2019). "Regulatable interleukin-12 gene therapy in patients with recurrent high-grade glioma: Results of a phase 1 Trial". Science translational medicine 11 (505): eaaw5680 .

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