{"title":"IDH-Mutant Gliomas","authors":"K. Tateishi, Tetsuya Yamamoto","doi":"10.5772/INTECHOPEN.84543","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84543","url":null,"abstract":"Isocitrate dehydrogenase ( IDH ) mutation is one of the most critical genomic alterations in lower grade and secondary glioblastoma patient. More than 90% of IDH mutation is located at codon R132 of IDH1 gene. IDH mutation produces oncometabolite “2-hydroxyglutarate” and induces epigenetic alteration, such as DNA global methylation and histone methylation. As a result, IDH mutation promotes early gliomagenesis. Since IDH mutation is the earliest genomic event and almost always retained during tumor progression, IDH mutation is expected as novel therapeutic target. Herein, we review the clinical characteristics of IDH -mutant gliomas, biological role of IDH mutation for gliomagenesis, and current and future therapeutic approach for IDH mutant tumors.","PeriodicalId":243134,"journal":{"name":"Brain and Spinal Tumors - Primary and Secondary","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126524465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Role of Radiotherapy in the Treatment of Primary Central Nervous System Lymphomas","authors":"M. Kurt, C. D. Abakay, A. Altay","doi":"10.5772/INTECHOPEN.84432","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84432","url":null,"abstract":"Primary central nervous system (PCNS) lymphomas are rare disease entities, though the incidence is increasing due to various immunosuppressive situations. The brain, eyes, and the spinal cord could be affected without any systemic disease involvement. Untreated PCNS lymphoma has been a rapidly fatal course. However, combined modality treatments have positive impact on overall survival. Pretreatment plan is formed by evaluating the treatment options to be used, disease involvement, and individual comorbidity. The PCNS lymphomas are known to be very sensitive to irradiation and chemotherapy treatments. The treatment plan is also generated according to the neurological condition and functional status of patients. The mainstay of induction therapy has been high dose methotrexate administration for most patients. The addition of radiotherapy as a consolidation treatment increases progression-free survival. The use of reduced irradiation dose and different fractionation schemes has been investigated in different studies to avoid the increased toxicity of high-dose whole-brain radiotherapy. High-dose chemotherapy, autologous hematopoietic cell transplantation, and whole-brain radiotherapy are alternative applications in patients with insufficient response to induction therapy. Stereotactic radiotherapy is another option in case of relapsed or refractory disease. Age and performance are also important indicators of survival and tumor progression. study of MTX, Rituximab and Temozolomide, plus hyperfractionated WBRT (36 Gy in twice daily 1.2 Gy fractions) in 66 patients with PCNSL was associated with an objective response rate of 85.7%. This study demonstrated that OS and PFS were improved compared with historical controls from RTOG-9310. Among patients, 66% had grade 3 and 4 toxicities before hWBRT, and 45% of patients experienced grade 3 and 4 toxicities attributable to post hWBRT chemotherapy.","PeriodicalId":243134,"journal":{"name":"Brain and Spinal Tumors - Primary and Secondary","volume":"51 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113961213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Principles of Neuropharmacodynamics: As Applied to Neuro-Oncology","authors":"A. Rodgers","doi":"10.5772/INTECHOPEN.82653","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.82653","url":null,"abstract":"The blood-brain barrier (BBB) is a highly selective semi-permeable membrane that separates the cerebral blood circulation from the brain and extracellular fluid in the central nervous system (CNS). The BBB is composed of endothelial cells, astrocyte end-feet and pericytes embedded in the capillary basement membrane. This system allows the passage of water, some gases and lipid-soluble molecules by passive diffusion, as well as, selective molecules such as glucose and amino acids. This review discusses pharmacodynamic concepts and methods that allow drugs to penetrate the BBB structure and enter the CNS and spinal nervous systems (SNS).","PeriodicalId":243134,"journal":{"name":"Brain and Spinal Tumors - Primary and Secondary","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128026652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Angiogenesis in Malignant Gliomas and Bevacizumab Resistance","authors":"S. Turner","doi":"10.5772/INTECHOPEN.84241","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84241","url":null,"abstract":"Standard therapy for malignant gliomas includes maximal resection followed by radiotherapy and temozolomide. The increase in neovascularization in high-grade gliomas serves the increased metabolic demands of these fast-growing tumors and the main pathway mediating this process involves vascular endothelial growth factor (VEGF) and its receptor. This pathway is targeted by bevacizumab (BEV), an anti-VEGF monoclonal antibody. Though preclinical trials with BEV were promising, clinical trials failed to show improvement in overall survival, and ultimately GBM become resistant to BEV. By better understanding the molecular mechanisms involved in angiogenesis, new targets may be identified and by elucidating the mechanism behind BEV resistance, new treatment modalities may be developed to treat these aggressive tumors.","PeriodicalId":243134,"journal":{"name":"Brain and Spinal Tumors - Primary and Secondary","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122331681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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