Primary brain tumours in adults.
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| Title: | Primary brain tumours in adults. |
|---|---|
| Authors: | van den Bent, Martin J (AUTHOR), Geurts, Marjolein (AUTHOR), French, Pim J (AUTHOR), Smits, Marion (AUTHOR), Capper, David (AUTHOR), Bromberg, Jacoline E C (AUTHOR), Chang, Susan M (AUTHOR) |
| Source: | Lancet. 10/28/2023, Vol. 402 Issue 10412, p1564-1579. 16p. |
| Subjects: | Brain tumors, Isocitrate dehydrogenase, Tumor microenvironment, Combination drug therapy, Molecular diagnosis, Adults, Ipilimumab |
| Abstract: | The most frequent adult-type primary CNS tumours are diffuse gliomas, but a large variety of rarer CNS tumour types exists. The classification of these tumours is increasingly based on molecular diagnostics, which is reflected in the extensive molecular foundation of the recent WHO 2021 classification of CNS tumours. Resection as extensive as is safely possible is the cornerstone of treatment in most gliomas, and is now also recommended early in the treatment of patients with radiological evidence of histologically low-grade tumours. For the adult-type diffuse glioma, standard of care is a combination of radiotherapy and chemotherapy. Although treatment with curative intent is not available, combined modality treatment has resulted in long-term survival (>10–20 years) for some patients with isocitrate dehydrogenase (IDH) mutant tumours. Other rarer tumours require tailored approaches, best delivered in specialised centres. Targeted treatments based on molecular alterations still only play a minor role in the treatment landscape of adult-type diffuse glioma, and today are mainly limited to patients with tumours with BRAF V600E (ie, Val600Glu) mutations. Immunotherapy for CNS tumours is still in its infancy, and so far, trials with checkpoint inhibitors and vaccination studies have not shown improvement in patient outcomes in glioblastoma. Current research is focused on improving our understanding of the immunosuppressive tumour environment, the molecular heterogeneity of tumours, and the role of tumour microtube network connections between cells in the tumour microenvironment. These factors all appear to play a role in treatment resistance, and indicate that novel approaches are needed to further improve outcomes of patients with CNS tumours. [ABSTRACT FROM AUTHOR] |
| Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 173236090 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Primary brain tumours in adults. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22van+den+Bent%2C+Martin+J%22">van den Bent, Martin J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Geurts%2C+Marjolein%22">Geurts, Marjolein</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22French%2C+Pim+J%22">French, Pim J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Smits%2C+Marion%22">Smits, Marion</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Capper%2C+David%22">Capper, David</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bromberg%2C+Jacoline+E+C%22">Bromberg, Jacoline E C</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chang%2C+Susan+M%22">Chang, Susan M</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 10/28/2023, Vol. 402 Issue 10412, p1564-1579. 16p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Brain+tumors%22">Brain tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Isocitrate+dehydrogenase%22">Isocitrate dehydrogenase</searchLink><br /><searchLink fieldCode="DE" term="%22Tumor+microenvironment%22">Tumor microenvironment</searchLink><br /><searchLink fieldCode="DE" term="%22Combination+drug+therapy%22">Combination drug therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Molecular+diagnosis%22">Molecular diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Ipilimumab%22">Ipilimumab</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: The most frequent adult-type primary CNS tumours are diffuse gliomas, but a large variety of rarer CNS tumour types exists. The classification of these tumours is increasingly based on molecular diagnostics, which is reflected in the extensive molecular foundation of the recent WHO 2021 classification of CNS tumours. Resection as extensive as is safely possible is the cornerstone of treatment in most gliomas, and is now also recommended early in the treatment of patients with radiological evidence of histologically low-grade tumours. For the adult-type diffuse glioma, standard of care is a combination of radiotherapy and chemotherapy. Although treatment with curative intent is not available, combined modality treatment has resulted in long-term survival (>10–20 years) for some patients with isocitrate dehydrogenase (IDH) mutant tumours. Other rarer tumours require tailored approaches, best delivered in specialised centres. Targeted treatments based on molecular alterations still only play a minor role in the treatment landscape of adult-type diffuse glioma, and today are mainly limited to patients with tumours with BRAF V600E (ie, Val600Glu) mutations. Immunotherapy for CNS tumours is still in its infancy, and so far, trials with checkpoint inhibitors and vaccination studies have not shown improvement in patient outcomes in glioblastoma. Current research is focused on improving our understanding of the immunosuppressive tumour environment, the molecular heterogeneity of tumours, and the role of tumour microtube network connections between cells in the tumour microenvironment. These factors all appear to play a role in treatment resistance, and indicate that novel approaches are needed to further improve outcomes of patients with CNS tumours. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/S0140-6736(23)01054-1 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 16 StartPage: 1564 Subjects: – SubjectFull: Brain tumors Type: general – SubjectFull: Isocitrate dehydrogenase Type: general – SubjectFull: Tumor microenvironment Type: general – SubjectFull: Combination drug therapy Type: general – SubjectFull: Molecular diagnosis Type: general – SubjectFull: Adults Type: general – SubjectFull: Ipilimumab Type: general Titles: – TitleFull: Primary brain tumours in adults. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: van den Bent, Martin J – PersonEntity: Name: NameFull: Geurts, Marjolein – PersonEntity: Name: NameFull: French, Pim J – PersonEntity: Name: NameFull: Smits, Marion – PersonEntity: Name: NameFull: Capper, David – PersonEntity: Name: NameFull: Bromberg, Jacoline E C – PersonEntity: Name: NameFull: Chang, Susan M IsPartOfRelationships: – BibEntity: Dates: – D: 28 M: 10 Text: 10/28/2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 01406736 Numbering: – Type: volume Value: 402 – Type: issue Value: 10412 Titles: – TitleFull: Lancet Type: main |
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