Prognostic and Predictive Biomarkers in Adult and Pediatric Gliomas: Toward Personalized Treatment

Abstract

It is increasingly clear that both adult and pediatric glial tumor entities represent collections of neoplastic lesions, each with individual pathological molecular events and treatment responses. In this review, we discuss the current prognostic biomarkers validated for clinical use or with future clinical validity for gliomas. Accurate prognostication is crucial for managing patients as treatments may be associated with high morbidity and the benefits of high risk interventions must be judged by the treating clinicians. We also review biomarkers with predictive validity, which may become clinically relevant with the development of targeted therapies for adult and pediatric gliomas.

Textbook of Personalized Medicine

“…Care will therefore be required to distinguish biomarkers that provide prognostic information from those that have predictive validity. This approach enable future personalized therapeutic choices with minimal toxicity and improve clinical outcomes for patients in whom the diagnosis of a malignant glioma still portends a dismal outlook (Haynes et al 2014 ).…”

Recent news in the glioblastoma research

“…As was mentioned above, genetic alterations emerging in GBL and related to the development of these tumors are described in a number of reviews [3][4][5]. Among these alterations are the impairments of sig naling pathways involving p53 and Rb, dysfunctions of receptor tyrosine kinase s (RTK), and signaling path way PI3K [5].…”

“…2) that are not mutually exclusive; therefore, dif ferent mechanisms may operate simultaneously. Infor mation concerning these factors was obtained in a large number of works (see, for example, reviews [3][4][5]). …”

“…Genetic alterations appearing in GBL and accom panying these tumors are described in a number of reviews (see, for example, [3][4][5]). However, it remained unclear until recently, how these alterations influence the functional activity of the brain cells.…”

Glioblastoma multiforme: emerging treatments and stratification markers beyond new drugs

“…25,26 Given the better prognosis for the secondary GBM, IDH mutations could therefore be assumed as a predictive biomarker. 27 However, the most important prognostic biomarker in clinical use for both primary and secondary GBM is MGMT promoter methylation. 16,17 In selected patient cohorts, MGMT promoter methylation might have even predictive value, e.g.…”