Gliomas: Symptoms, Diagnosis and Treatment Options


Marzenna Wiranowska, PhD (Editor)
Associate Professor, University of South Florida, Department of Pathology Cell Biology, College of Medicine, Tampa, FL, USA

Frank D. Vrionis, PhD (Editor)
Chief of Neurosurgery, H. Lee Moffitt Cancer Center, Tampa, FL
Professor, Neurosurgery, Orthopedics and Oncology, University of South Florida College of Medicine, Tampa, FL

Series: Cancer Etiology, Diagnosis and Treatments
BISAC: MED062000

This book reviews the biology, current treatment modalities and new emerging therapeutic approaches and targets for glioma, a highly aggressive and invasive brain tumor.

In the first section entitled “Symptoms and Diagnosis” the pathologic features of the most frequently WHO classified gliomas encountered in the clinical practice, are described. The molecular genetics and specifically the mutations that underlie brain tumors are outlined. The inherited genetic susceptibility and lifestyle risk factors reflecting on glioma epidemiology are discussed. With regard to “Diagnosis”, the clinical features of glioma as well as diagnostic methods that include conventional and advanced magnetic resonance imaging (MRI) and brain mapping are described. These brain mapping techniques are used pre and intraoperative in glioma surgery and allow the identification of the cortical and subcortical functional pathways to maximize the extent of glioma resection while decreasing the risk of postoperative neurological deficits.

In the second section entitled “Current Treatment Options” the available therapies are discussed. They include surgery, chemotherapy, and radiation with specific focus on newly developed, dose rate modulated re-treatment irradiation for recurrent glioma patients. In this approach the radiation is delivered below standard dose-rates resulting in reduced normal tissue toxicity but significant tumor regression. Targeted therapies are discussed especially the anti-angiogenic therapies for which expectations were high, but so far have not match clinical outcome. In addition, therapies for cerebrospinal fluid disseminated disease or leptomeningeal metastasis (LMD), a common problem in neuro-oncology patients are discussed. Finally, treatments for the neurological complications of glioma management that are not directly related to tumor eradication are outlined.

In the third and final section of this book entitled “Future Treatment Options: New Targets and Experimental Therapies” some of the new emerging therapeutic approaches and targets for glioma are reviewed. These include targeting cancer stem cells, the vascular niche and the extracellular matrix components that provide support for these cells. Other innovative therapeutic approaches include targeting of glioma-associated antigens and the development of immunotherapeutics and oncolytic viruses targeting these antigens. In addition, targeting of glioma pathways such as PTEN/AKT involved in cell proliferation, adhesion and apoptosis and the thiol-based redox system, the basis of chemotherapeutic resistance characteristic of glioma cell biology are discussed as well.

Also, reviewed are new approaches (with some being in clinical trials) for targeting glioma with anti-cancer cytotoxins, such as interleukin 13 (IL-13)-based cytotoxin and glioma targeting peptides such as scorpion derived neurotoxin, chlorotoxin evaluated in anti-glioma therapeutics delivery. Finally, nanoparticles based systems are reviewed representing a new modality for the delivery of therapeutics to brain tumors with some systems such as magnetic nanoparticles being currently in clinical trials. This new rapidly developing field of nanotechnology enabled delivery often employs targeting molecules such as antibodies against glioma antigens and chlorotoxin. In summary, this book provides a compilation of the most recent information in the field of glioma biology, diagnosis and current as well as an emerging treatment options for glioma. (Imprint: Nova Biomedical )

Table of Contents

Table of Contents

Section I. Symptoms and Diagnosis

Chapter 1. Epidemiology of Gliomas
(Gabriella M. Anic and Kathleen M. Egan, Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute,
Tampa, FL, USA)

Chapter 2. Pathology of Gliomas
(Ada Baisre, Nitin Agarwal and Amyn M. Rojiani, UMDNJ-New Jersey Medical School, Newark, NJ, USA and others)

Chapter 3. Molecular Genetics of Brain Tumors
(Kyriakos Papadimitriou, Chetan Bettegowda and Frank Vrionis, Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA and others)
<a href=”” target=”_blank” rel=”noopener”>Free Download Available</a>

Chapter 4. Clinical Features of Central Nervous System Tumors
(Tsz Lau, Timothy D. Miller, Nam D. Tran, Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, USA)

Chapter 5. Neuro Imaging of Malignant Gliomas
(Ryan Murtagh, University of South Florida, Tampa, FL, USA)

Chapter 6. Intra-operative Brain Mapping in Glioma Surgery
(Matthew C. Tate and Mitchel S. Berger, Department of Neurological Surgery, University of California, San Francisco, CA, USA)

Chapter 7. Preoperative Brain Mapping in Glioma Surgery
(Surbhi Jain, Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA)

Section II. Current Treatment Options

Chapter 8. Neurological Complications of Gliomas
(Edward Bass, Department Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA)

Chapter 9. Radiation Therapy in the Management of Glioma
(David Page, Jacob Scott and Hsiang-Hsuan Michael Yu, Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA and others)

Chapter 10. Dose Rate Modulation for the Safe Delivery of Retreatment Irradiation in Recurrent Glioma Patients
(H. Ian Robins, Wolfgang A. Tomé and Steve P. Howard, Departments of Medicine, Human Oncology, Neurology, Medical Physics and Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA)

Chapter 11. Targeted Therapies for Malignant Gliomas
(Noman Ashraf and Edward Pan, Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA)

Chapter 12. Antiangiogenic Therapies for High-Grade Glioma
(Tara L. Benkers and Patrick Y. Wen, Center for Neuro-Oncology, Dana Farber/Brigham and Women’s Cancer Center, Boston, MA, USA and others)

Chapter 13. CSF Dissemination of Gliomas and Primary Brain Tumors
(Marc C. Chamberlain, Department of Neurology and Neurological Surgery University of Washington Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, USA)

Section III. Future Treatment Options: New Targets & Experimental Therapies

Chapter 14. Stem Cell Biology as it Relates to Glioma Pathogenesis and Treatment
(Brienne A. McKenzie, Ebba U. Kurz and Peter Forsyth, University of Calgary, Southern Alberta Cancer Research Institute, Calgary, Alberta Canada and others)
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Chapter 15. Glioma Extracellular Matrix Molecules as Therapeutic Targets
(Marzenna Wiranowska and Mumtaz V. Rojiani, Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA and others)

Chapter 16. Current Immunotherapeutic Targets in Gliomas
(Vidyalakshmi Chandramohan, Duane A. Mitchell, Matthias Gromeier, John H. Sampson and Darell D. Bigner, Departments of Pathology and Surgery, Duke University Medical Center, Durham, NC, USA)

Chapter 17. The Significance of PTEN/Akt Pathway in Glioma and its Relation to Proliferation, Adhesion and Apoptosis of Glioma Cells
(C. S. K. Luk and S. S. T. To, Department of Health Technology and Informatics, the Hong Kong Polytechnic University, Hong Kong SAR, China)

Chapter 18. The Thiol Redox System in Glioma Biology: Clinical Target and Significance in Resistance to Glioma Chemotherapy
(Gethin J. McBean, UCD School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Belfield, Dublin, Ireland)

Chapter 19. Loco-Regional and Targeted Therapy of Glioma with Chlorotoxin
(Michael Schiraldi and Adam N. Mamelak, Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA)

Chapter 20. Cytokine-Directed Recombinant Cytotoxins for Glioma Treatment
(Waldemar Debinski, Brain Tumor Center of Excellence, Wake Forest School of Medicine Departments Neurosurgery, Radiation Oncology and Cancer Biology, Comprehensive Cancer Center, Winston-Salem, NC, USA)

Chapter 21. Nanoparticle Based Delivery of Therapeutics to Glioma
(Eva Christabel Williams, Norma A. Alcantar and Marzenna Wiranowska, University of South Florida, Tampa, FL, USA)
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