Pathways to hypermutation in high-grade gliomas: Mechanisms, syndromes, and opportunities for immunotherapy.

IF 3.7 Q1 CLINICAL NEUROLOGY
Neuro-oncology advances Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI:10.1093/noajnl/vdae105
Tuesday Haynes, Mark R Gilbert, Kevin Breen, Chunzhang Yang
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引用次数: 0

Abstract

Despite rapid advances in the field of immunotherapy, including the success of immune checkpoint inhibition in treating multiple cancer types, clinical response in high-grade gliomas (HGGs) has been disappointing. This has been in part attributed to the low tumor mutational burden (TMB) of the majority of HGGs. Hypermutation is a recently characterized glioma signature that occurs in a small subset of cases, which may open an avenue to immunotherapy. The substantially elevated TMB of these tumors most commonly results from alterations in the DNA mismatch repair pathway in the setting of extensive exposure to temozolomide or, less frequently, from inherited cancer predisposition syndromes. In this review, we discuss the genetics and etiology of hypermutation in HGGs, with an emphasis on the resulting genomic signatures, and the state and future directions of immuno-oncology research in these patient populations.

高级别胶质瘤的高突变途径:免疫疗法的机制、综合征和机遇。
尽管免疫疗法领域进展迅速,包括免疫检查点抑制剂成功治疗了多种癌症类型,但高级别胶质瘤(HGGs)的临床反应却令人失望。部分原因是大多数高级别胶质瘤的肿瘤突变负荷(TMB)较低。高突变是最近发现的胶质瘤特征,发生在一小部分病例中,这可能为免疫疗法开辟了一条途径。这些肿瘤的TMB大幅升高,最常见的原因是广泛接触替莫唑胺后DNA错配修复途径发生了改变,或者是遗传性癌症易感综合征,但这种情况并不常见。在这篇综述中,我们将讨论 HGGs 高突变的遗传学和病因学,重点是由此产生的基因组特征,以及这些患者群体的免疫肿瘤学研究现状和未来方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.20
自引率
0.00%
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0
审稿时长
12 weeks
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