Abstract
Gliomas are the most common central nervous system tumors. New technologies, including genetic research and advanced statistical methods, revolutionize the therapeutic approach to the patient and reveal new points of treatment options. Moreover, the 2021 World Health Organization Classification of Tumors of the Central Nervous System has fundamentally changed the classification of gliomas and incorporated many molecular biomarkers. Given the rapid progress in neuro-oncology, here we compile the latest research on prognostic and predictive biomarkers in gliomas. In adult patients, IDH mutations are positive prognostic markers and have the greatest prognostic significance. However, CDKN2A deletion, in IDH-mutant astrocytomas, is a marker of the highest malignancy grade. Moreover, the presence of TERT promoter mutations, EGFR alterations, or a combination of chromosome 7 gain and 10 loss upgrade IDH-wildtype astrocytoma to glioblastoma. In pediatric patients, H3F3A alterations are the most important markers which predict the worse outcome. MGMT promoter methylation has the greatest clinical significance in predicting responses to temozolomide (TMZ). Conversely, mismatch repair defects cause hypermutation phenotype predicting poor response to TMZ. Finally, we discussed liquid biopsies, which are promising diagnostic, prognostic, and predictive techniques, but further work is needed to implement these novel technologies in clinical practice.
Highlights
Gliomas, broadly categorized by their cell of origin, are the most common central nervous system (CNS) tumors [1]
Vuong et al reported that not all GBM patients with methylated methylguanine-DNA methyltransferase (MGMT) may benefit from TMZ, postulating that it is possible that only GBM patients mutated by telomerase reverse transcriptase (TERT)
Investigated whether a specific blood-derived miRNA fingerprint could be defined in glioblastoma patients, and in doing so showed that miRNAs can be considered as biomarkers and their detection in the blood justifies the need for further testing [197]
Summary
Broadly categorized by their cell of origin, are the most common central nervous system (CNS) tumors [1]. The initial management of gliomas usually consists of maximally safe surgical resection, which in addition to reducing tumor volume allows for tissue acquisition for an accurate histological diagnosis and tumor genotyping [9]. This is often followed by radiotherapy (RT) and temozolomide (TMZ) chemotherapy [10]. Prognostic and predictive markers play an important role in clinical practice for the assessment of prognosis and the selection of appropriate therapy This is especially important in gliomas due to the possible occurrence of so-called pseudoprogression in MRI [15]. Due to the rapid progress in neuro-oncology, here we compile the latest research on prognostic and predictive biomarkers in gliomas
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
