Abstract
Glioma is the most common and aggressive primary tumor of the central nervous system. The standard treatment for malignant gliomas is surgery followed by chemoradiotherapy. Unfortunately, this treatment has not produced an adequate patient response, resulting in a median survival time of 12–15 months and a 5-year overall survival of <5%. Although new strategies have been sought to enhance patient response, no significant increase in the global survival of glioma patients has been achieved. The option of developing new drugs implies a long and costly process, making drug repurposing a more practical alternative for improving glioma treatment. In the last few years, researchers seeking more effective cancer therapy have pursued the possibility of using anti-hormonal agents, such as mifepristone. The latter drug, an antagonist for progesterone and glucocorticoid receptors, has several attractive features: anti-tumor activity, low cytotoxicity to healthy cells, and modulation of the chemosensitivity of several cancer cell lines in vitro. Hence, the addition of mifepristone to temozolomide-based glioblastoma chemotherapy may lead to a better patient response. The mechanisms by which mifepristone enhances glioma treatment are not yet known. The current review aims to discuss the potential role of mifepristone as an adjuvant drug for the treatment of high-grade gliomas.
Highlights
Glioma is the most common primary neoplasm in the central nervous system, making up approximately 30–45% of tumors in the central nervous system (CNS)
An experimental and clinical study on human glioma cells, on an animal model, and in patients with recurrent glioblastoma multiforme (GBM) demonstrated that the combination of temozolomide with inhibitors of the tumor promoter gene GSK3b reduces in the progression of the disease and protects against the neurodegenerative effects provoked by radiotherapy [27]
We find that there was an additive effect by temozolamide and mifepristone in the inhibition of vascular endothelial growth factor (VEGF) levels
Summary
Glioma is the most common primary neoplasm in the central nervous system, making up approximately 30–45% of tumors in the central nervous system (CNS). The methylation of the CpG island of the MGMT enzyme promoter is associated with better survival of patients with high grade gliomas that are given alkylating agents as chemotherapy. Despite extensive research on the design and development of new molecules to achieve a better response to glioma treatment, patient overall survival, and the median survival time have not yet improved.
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