Abstract
Despite their low incidence rate globally, high-grade gliomas (HGG) remain a fatal primary brain tumor. The recommended therapy often is incapable of resecting the tumor entirely and exclusively targeting the tumor leads to tumor recurrence and dismal prognosis. Additionally, many HGG patients are not well suited for standard therapy and instead, subjected to a palliative approach. HGG tumors are highly infiltrative and the complex tumor microenvironment as well as high tumor heterogeneity often poses the main challenges towards the standard treatment. Therefore, a one-fit-approach may not be suitable for HGG management. Thus, a multimodal approach of standard therapy with immunotherapy, nanomedicine, repurposing of older drugs, use of phytochemicals, and precision medicine may be more advantageous than a single treatment model. This multimodal approach considers the environmental and genetic factors which could affect the patient’s response to therapy, thus improving their outcome. This review discusses the current views and advances in potential HGG therapeutic approaches and, aims to bridge the existing knowledge gap that will assist in overcoming challenges in HGG.
Highlights
Cancer is categorized by the World Health Organization (WHO) as the second deadliest disease, with an estimated death of 9.6 million globally in 2018 [1]
This study indicated that IDH1 mutation has a favorable prognosis than the methylation of MGMT promoter or 1p/19q co-deletion
Anaplastic astrocytoma with IDH1 wild-type and MGMT methylation patients may be more suitable treated with chemotherapy and if the MGMT is unmethylated, they are better treated by radiotherapy only
Summary
Cancer is categorized by the World Health Organization (WHO) as the second deadliest disease, with an estimated death of 9.6 million globally in 2018 [1]. The median overall survival is between 15–23 months and a low five-year survival rate (between 2007–2011) [4,13,16] This can be due to surgical resection’s inefficacy to fully resect the tumor and lack of effective therapeutic approaches to exclusively target. Research has looked into the potentiality of natural products as nutraceutical-based adjuvants [19,20,21] This present review aims to discuss the current views of drug development and therapy in HGG. The highlights and discussion in this review aim to improve the existing knowledge and bridge the gap in HGG research and advancement, in the last decade We hope this will provide a more comprehensive understanding of the development of more precise, effective, and personalized therapy in HGG patients
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