Clinical diagnosis and treatment of glioma: accumulate small step, ready to surpass

doi:10.3969/j.issn.1672-6731.2019.11.002

Abstract

Abstract:

Glioma is the most common primary central nervous system malignancy, which is a fatal and poorly prognostic tumor. Recent years, basic research, clinical diagnosis and treatment as well as various clinical trials related to glioma have been emerged. This article mainly explains the possible changes in the fifth edition of WHO Central Nervous System Tumor Classification and summarizes both the achievements and shortcomings in the development of the glioma diagnosis and treatment standard in China and also elaborates that the Glioblastoma Multiforme Adaptive Global Innovative Learning Environment (GBM AGILE), a new clinical trial system, plays a positive role in the development of the China's precision medical strategy and the pharmaceutical industry driven by scientific and technological innovation.

Key words: Glioma, Integrated diagnosis (not in MeSH), Guidelines, Review

摘要：

脑胶质瘤是临床最为常见的原发性中枢神经系统恶性肿瘤，是一种致死性强且预后差的肿瘤。近年来，与脑胶质瘤相关的基础研究、临床诊断与治疗及各种临床试验层出不穷。本文主要对WHO中枢神经系统肿瘤分类第五版可能出现的部分变化进行解读；总结我国脑胶质瘤诊断与治疗指南或规范制定过程中的里程碑事件及存在不足；阐述新型临床试验体系——全球脑胶质母细胞瘤适应性临床创新试验体系（GBM AGILE）对我国精准医疗战略及以科技创新为驱动的医药产业的发展的积极作用。

关键词: 神经胶质瘤, 整合诊断(非MeSH词), 指南, 综述

YANG Xue-jun, JIANG Tao. Clinical diagnosis and treatment of glioma: accumulate small step, ready to surpass[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2019, 19(11): 801-806.

杨学军, 江涛. 脑胶质瘤临床诊断与治疗：积于跬步蓄势超越[J]. 中国现代神经疾病杂志, 2019, 19(11): 801-806.

/ / Recommend / Download Citations

URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2019.11.002

https://journal11.magtechjournal.com/cjcnn/EN/Y2019/V19/I11/801

References

[1] Bailey P, Cushing H. A classification of the tumors of the glioma group on a histogenetic basis with a correlated study of prognosis[M]. Philadelphia:London and Montreal, 1926.
[2] Zhao JZ, Zhou DB. Neurosurgery[M]. 3rd ed. Beijing:People's Medical Publishing House, 2014:191-194.[赵继宗,周定标.神经外科学[M]. 3版.北京:人民卫生出版社, 2014:191-194.]
[3] Kernohan JW, Mabon RF. A simplified classification of the gliomas[J]. Proc Staff Meet Mayo Clin, 1949, 24:71-75.
[4] van den Bent MJ. Interobserver variation of the histopathological diagnosis in clinical trials on glioma:a clinician's perspective[J]. Acta Neuropathol, 2010, 120:297-304.
[5] Cancer Genome Atlas Research Network; Brat DJ, Verhaak RG, Aldape KD, Yung WK, Salama SR, Cooper LA, Rheinbay E, Miller CR, Vitucci M, Morozova O, Robertson AG, Noushmehr H, Laird PW, Cherniack AD, Akbani R, Huse JT, Ciriello G, Poisson LM, Barnholtz-Sloan JS, Berger MS, Brennan C, Colen RR, Colman H, Flanders AE, Giannini C, Grifford M, Iavarone A, Jain R, Joseph I, Kim J, Kasaian K, Mikkelsen T, Murray BA, O'Neill BP, Pachter L, Parsons DW, Sougnez C, Sulman EP, Vandenberg SR, Van Meir EG, von Deimling A, Zhang H, Crain D, Lau K, Mallery D, Morris S, Paulauskis J, Penny R, Shelton T, Sherman M, Yena P, Black A, Bowen J, Dicostanzo K, Gastier-Foster J, Leraas KM, Lichtenberg TM, Pierson CR, Ramirez NC, Taylor C, Weaver S, Wise L, Zmuda E, Davidsen T, Demchok JA, Eley G, Ferguson ML, Hutter CM, Mills Shaw KR, Ozenberger BA, Sheth M, Sofia HJ, Tarnuzzer R, Wang Z, Yang L, Zenklusen JC, Ayala B, Baboud J, Chudamani S, Jensen MA, Liu J, Pihl T, Raman R, Wan Y, Wu Y, Ally A, Auman JT, Balasundaram M, Balu S, Baylin SB, Beroukhim R, Bootwalla MS, Bowlby R, Bristow CA, Brooks D, Butterfield Y, Carlsen R, Carter S, Chin L, Chu A, Chuah E, Cibulskis K, Clarke A, Coetzee SG, Dhalla N, Fennell T, Fisher S, Gabriel S, Getz G, Gibbs R, Guin R, Hadjipanayis A, Hayes DN, Hinoue T, Hoadley K, Holt RA, Hoyle AP, Jefferys SR, Jones S, Jones CD, Kucherlapati R, Lai PH, Lander E, Lee S, Lichtenstein L, Ma Y, Maglinte DT, Mahadeshwar HS, Marra MA, Mayo M, Meng S, Meyerson ML, Mieczkowski PA, Moore RA, Mose LE, Mungall AJ, Pantazi A, Parfenov M, Park PJ, Parker JS, Perou CM, Protopopov A, Ren X, Roach J, Sabedot TS, Schein J, Schumacher SE, Seidman JG, Seth S, Shen H, Simons JV, Sipahimalani P, Soloway MG, Song X, Sun H, Tabak B, Tam A, Tan D, Tang J, Thiessen N, Triche T Jr, Van Den Berg DJ, Veluvolu U, Waring S, Weisenberger DJ, Wilkerson MD, Wong T, Wu J, Xi L, Xu AW, Yang L, Zack TI, Zhang J, Aksoy BA, Arachchi H, Benz C, Bernard B, Carlin D, Cho J, DiCara D, Frazer S, Fuller GN, Gao J, Gehlenborg N, Haussler D, Heiman DI, Iype L, Jacobsen A, Ju Z, Katzman S, Kim H, Knijnenburg T, Kreisberg RB, Lawrence MS, Lee W, Leinonen K, Lin P, Ling S, Liu W, Liu Y, Liu Y, Lu Y, Mills G, Ng S, Noble MS, Paull E, Rao A, Reynolds S, Saksena G, Sanborn Z, Sander C, Schultz N, Senbabaoglu Y, Shen R, Shmulevich I, Sinha R, Stuart J, Sumer SO, Sun Y, Tasman N, Taylor BS, Voet D, Weinhold N, Weinstein JN, Yang D, Yoshihara K, Zheng S, Zhang W, Zou L, Abel T, Sadeghi S, Cohen ML, Eschbacher J, Hattab EM, Raghunathan A, Schniederjan MJ, Aziz D, Barnett G, Barrett W, Bigner DD, Boice L, Brewer C, Calatozzolo C, Campos B, Carlotti CG Jr, Chan TA, Cuppini L, Curley E, Cuzzubbo S, Devine K, DiMeco F, Duell R, Elder JB, Fehrenbach A, Finocchiaro G, Friedman W, Fulop J, Gardner J, Hermes B, Herold-Mende C, Jungk C, Kendler A, Lehman NL, Lipp E, Liu O, Mandt R, McGraw M, Mclendon R, McPherson C, Neder L, Nguyen P, Noss A, Nunziata R, Ostrom QT, Palmer C, Perin A, Pollo B, Potapov A, Potapova O, Rathmell WK, Rotin D, Scarpace L, Schilero C, Senecal K, Shimmel K, Shurkhay V, Sifri S, Singh R, Sloan AE, Smolenski K, Staugaitis SM, Steele R, Thorne L, Tirapelli DP, Unterberg A, Vallurupalli M, Wang Y, Warnick R, Williams F, Wolinsky Y, Bell S, Rosenberg M, Stewart C, Huang F, Grimsby JL, Radenbaugh AJ, Zhang J. Comprehensive, integrative genomic analysis of diffuse lower-grade gliomas[J]. N Engl J Med, 2015, 372:2481-2498.
[6] Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW. The 2016 World Health Organization classification of tumors of the central nervous system:a summary[J]. Acta Neuropathol, 2016, 131:803-820.
[7] Louis DN, Ellison DW, Brat DJ, Aldape K, Capper D, Hawkins C, Paulus W, Perry A, Reifenberger G, Figarella-Branger D, von Deimling A, Wesseling P. cIMPACT-NOW:a practical summary of diagnostic points from Round 1 updates[J]. Brain Pathol, 2019, 29:469-472.
[8] Louis DN, Giannini C, Capper D, Paulus W, Figarella-Branger D, Lopes MB, Batchelor TT, Cairncross JG, van den Bent M, Wick W, Wesseling P. cIMPACT-NOW update 2:diagnostic clarifications for diffuse midline glioma, H3 K27M-mutant and diffuse astrocytoma/anaplastic astrocytoma, IDH-mutant[J]. Acta Neuropathol, 2018, 135:639-642.
[9] Brat DJ, Aldape K, Colman H, Holland EC, Louis DN, Jenkins RB, Kleinschmidt-DeMasters BK, Perry A, Reifenberger G, Stupp R, von Deimling A, Weller M. cIMPACT-NOW update 3:recommended diagnostic criteria for "Diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade Ⅳ" [J]. Acta Neuropathol, 2018, 136:805-810.
[10] Ellison DW, Hawkins C, Jones DTW, Onar-Thomas A, Pfister SM, Reifenberger G, Louis DN. cIMPACT-NOW update 4:diffuse gliomas characterized by MYB, MYBL1, or FGFR1 alterations or BRAF V600E mutation[J]. Acta Neuropathol, 2019, 137:683-687.
[11] Cimino PJ, Zager M, McFerrin L, Wirsching HG, Bolouri H, Hentschel B4, von Deimling A, Jones D, Reifenberger G, Weller M, Holland EC. Multidimensional scaling of diffuse gliomas:application to the 2016 World Health Organization classification system with prognostically relevant molecular subtype discovery[J]. Acta Neuropathol Commun, 2017, 5:39.
[12] Oncology Group, Neurosurgery Branch, Chinese Medical Association. Consensus on diagnosis and treatment of glioblastoma of central nervous system in China (simplified version)[J]. Zhonghua Yi Xue Za Zhi, 2009, 89:3028-3030.[中华医学会神经外科分会肿瘤专业组.中国中枢神经系统恶性胶质瘤诊断和治疗共识(简化版)[J].中华医学杂志, 2009, 89:3028-3030.]
[13] Writing Group of "Chinese guidelines for diagnosis and treatment of central nervous system glioma" . Chinese guidelines for diagnosis and treatment of central nervous system glioma (2012)[J]. Zhonghua Yi Xue Za Zhi, 2013, 93:2418-2449.[《中国中枢神经系统胶质瘤诊断和治疗指南》编写组.中国中枢神经系统胶质瘤诊断和治疗指南(2012)[J].中华医学杂志, 2013, 93:2418-2449.]
[14] Writing Group of Chinese guidelines for diagnosis and treatment of central nervous system glioma. Chinese guidelines for diagnosis and treatment of central nervous system glioma (2015)[J]. Zhonghua Yi Xue Za Zhi, 2016, 93:485-509.[《中国中枢神经系统胶质瘤诊断和治疗指南》编写组.中国中枢神经系统胶质瘤诊断与治疗指南(2015)[J].中华医学杂志, 2016, 93:485-509.]
[15] Chinese Glioma Cooperative Group. Surgical guidelines for excision of brain functional areas of glioma in the wake state (2014)[J]. Zhongguo Wei Qin Xi Shen Jing Wai Ke Za Zhi, 2014, 20:479-485.[中国脑胶质瘤协作组.唤醒状态下切除脑功能区胶质瘤手术技术指南(2014版)[J].中国微侵袭神经外科杂志, 2014, 20:479-485.]
[16] Chinese Glioma Cooperative Group. Surgical guidelines for excision of brain functional areas of glioma in the wake state (2018)[J]. Zhongguo Wei Qin Xi Shen Jing Wai Ke Za Zhi, 2018, 23:383-388.[中国脑胶质瘤协作组,中国医师协会脑胶质瘤专业委员会.唤醒状态下切除脑功能区胶质瘤手术技术指南(2018版)[J].中国微侵袭神经外科杂志, 2018, 23:383-388.]
[17] Chinese Glioma Cooperative Group (CGCG). Guidelines for surgical treatment of low-grade supratentorial gliomas in adults[J]. Zhonghua Shen Jing Wai Ke Za Zhi, 2016, 32:652-658.[中国脑胶质瘤协作组(CGCG).成人幕上低级别胶质瘤的手术治疗指南[J].中华神经外科杂志, 2016, 32:652-658.]
[18] Chinese Glioma Cooperative Group, Chinese Glioma Genome Atlas. Chinese guidelines for molecular diagnosis and treatment of brain glioma[J]. Zhonghua Shen Jing Wai Ke Za Zhi, 2014, 30:435-444.[中国脑胶质瘤协作组,中国脑胶质瘤基因组图谱计划.中国脑胶质瘤分子诊疗指南[J].中华神经外科杂志, 2014, 30:435-444.]
[19] Jiang T, Mao Y, Ma W, Mao Q, You Y, Yang X, Jiang C, Kang C, Li X, Chen L, Qiu X, Wang W, Li W, Yao Y, Li S, Li S, Wu A, Sai K, Bai H, Li G, Chen B, Yao K, Wei X, Liu X, Zhang Z, Dai Y, Lv S, Wang L, Lin Z, Dong J, Xu G, Ma X, Cai J, Zhang W, Wang H, Chen L, Zhang C, Yang P, Yan W, Liu Z, Hu H, Chen J, Liu Y, Yang Y, Wang Z, Wang Z, Wang Y, You G, Han L, Bao Z, Liu Y, Wang Y, Fan X, Liu S, Liu X, Wang Y, Wang Q; Chinese Glioma Cooperative Group (CGCG). CGCG clinical practice guidelines for the management of adult diffuse gliomas[J]. Cancer Lett, 2016, 375:263-273.
[20] Oncology Group, Neurosurgery Branch, Chinese Medical Association; Chinese Expert Consensus Writing Committee on Comprehensive Diagnosis and Treatment of Brain Stem Glioma. Consensus of Chinese experts on comprehensive diagnosis and treatment of brain stem glioma[J]. Zhonghua Shen Jing Wai Ke Za Zhi, 2017, 33:217-229.[中华医学会神经外科学分会肿瘤学组,脑干胶质瘤综合诊疗中国专家共识编写委员会.脑干胶质瘤综合诊疗中国专家共识[J].中华神经外科杂志, 2017, 33:217-229.]
[21] Radiation Oncology Branch, Chinese Medical Association. Consensus of Chinese experts on glioma radiotherapy (2017)[J]. Zhonghua Fang She Zhong Liu Xue Za Zhi, 2018, 27:123-131.[中华医学会放射肿瘤治疗学分会.胶质瘤放疗中国专家共识(2017)[J].中华放射肿瘤学杂志, 2018, 27:123-131.]
[22] Brain Glioma Committee, Chinese Medical Doctor Association; Neuro-Tumor Branch of Shanghai Anti-Cancer Association. Consensus of experts on immune and targeted therapy of glioma of central nervous system in China[J]. Zhonghua Yi Xue Za Zhi, 2018, 98:324-331.[中国医师协会脑胶质瘤专业委员会,上海市抗癌协会神经肿瘤分会.中国中枢神经系统胶质瘤免疫和靶向治疗专家共识[J].中华医学杂志, 2018, 98:324-331.]
[23] Brain Glioma Committee, Chinese Medical Doctor Association. Consensus of Chinese experts on multidisciplinary diagnosis and treatment (MDT) of glioma[J]. Zhonghua Shen Jing Wai Ke Za Zhi, 2018, 34:113-118.[中国医师协会神经外科医师分会脑胶质瘤专业委员会.胶质瘤多学科诊治(MDT)中国专家共识[J].中华神经外科杂志, 2018, 34:113-118.]
[24] Liang S, Fan X, Zhao M, Shan X, Li W, Ding P, You G, Hong Z, Yang X, Luan G, Ma W, Yang H, You Y, Yang T, Li L, Liao W, Wang L, Wu X, Yu X, Zhang J, Mao Q, Wang Y, Li W, Wang X, Jiang C, Liu X, Qi S, Liu X, Qu Y, Xu J, Wang W, Song Z, Wu J, Liu Z, Chen L, Lin Y, Zhou J, Liu X, Zhang W, Li S, Jiang T. Clinical practice guidelines for the diagnosis and treatment of adult diffuse glioma-related epilepsy[J]. Cancer Med, 2019, 8:4527-4535.
[25] National Health Commission Medical Administration. Diagnosis and treatment of brain glioma (2018)[J]. Zhonghua Shen Jing Wai Ke Za Zhi, 2019, 35:217-239.[国家卫生健康委员会医政医管局.脑胶质瘤诊疗规范(2018年版)[J].中华神经外科杂志, 2019, 35:217-239.]
[26] Alexander BM, Ba S, Berger MS, Berry DA, Cavenee WK, Chang SM, Cloughesy TF, Jiang T, Khasraw M, Li W, Mittman R, Poste GH, Wen PY, WKA Y, Barker AD. Adaptive global innovative learning environment for glioblastoma:GBM AGILE[J]. Clin Cancer Res, 2018, 24:737-743.

Please choose a citation manager

Content to export