Cerebellar High-Grade Glioma: A Translationally Oriented Review of the Literature.
Ashley Laurence Bharat RaghuJason A ChenPablo A ValdesWalid I B N EssayedElizabeth ClausOmar ArnaoutTimothy R SmithE Antonio ChioccaPier Paolo PeruzziJoshua D BernstockPublished in: Cancers (2022)
World Health Organization (WHO) grade 4 gliomas of the cerebellum are rare entities whose understanding trails that of their supratentorial counterparts. Like supratentorial high-grade gliomas (sHGG), cerebellar high-grade gliomas (cHGG) preferentially affect males and prognosis is bleak; however, they are more common in a younger population. While current therapy for cerebellar and supratentorial HGG is the same, recent molecular analyses have identified features and subclasses of cerebellar tumors that may merit individualized targeting. One recent series of cHGG included the subclasses of (1) high-grade astrocytoma with piloid features (HGAP, ~31% of tumors); (2) H3K27M diffuse midline glioma (~8%); and (3) isocitrate dehydrogenase (IDH) wildtype glioblastoma (~43%). The latter had an unusually low-frequency of epidermal growth factor receptor (EGFR) and high-frequency of platelet-derived growth factor receptor alpha (PDGFRA) amplification, reflecting a different composition of methylation classes compared to supratentorial IDH-wildtype tumors. These new classifications have begun to reveal insights into the pathogenesis of HGG in the cerebellum and lead toward individualized treatment targeted toward the appropriate subclass of cHGG. Emerging therapeutic strategies include targeting the mitogen-activated protein kinases (MAPK) pathway and PDGFRA, oncolytic virotherapy, and immunotherapy. HGGs of the cerebellum exhibit biological differences compared to sHGG, and improved understanding of their molecular subclasses has the potential to advance treatment.
Keyphrases
- high grade
- low grade
- epidermal growth factor receptor
- high frequency
- growth factor
- tyrosine kinase
- cancer therapy
- small cell lung cancer
- transcranial magnetic stimulation
- advanced non small cell lung cancer
- dna methylation
- signaling pathway
- genome wide
- gene expression
- pi k akt
- combination therapy
- single molecule
- risk assessment
- wild type
- human health