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Erschienen in: Der Nervenarzt 8/2010

01.08.2010 | Leitthema

Anaplastische Gliome

Neuropathologie, molekulare Diagnostik und aktuelle Studienkonzepte

verfasst von: Prof. Dr. W. Wick, M. Weller

Erschienen in: Der Nervenarzt | Ausgabe 8/2010

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Zusammenfassung

Anaplastische Gliome umfassen nach der aktuell gültigen WHO-Klassifikation reine Astrozytome, reine Oligodendrogliome und „gemischte“ Oligoastrozytome. Die molekularen Subgruppenanalysen der NOA-04-Studie haben drei molekulare Marker identifiziert, die unabhängig von der Art der Therapie – Strahlentherapie oder Chemotherapie mit Alkylanzien – die Vorhersage eines längeren progressionsfreien und Gesamtüberlebens erlauben: die 1p/19q-Kodeletion, die O6-Methylguanylmethyltransferase (MGMT)-Promotor-Methylierung und Mutationen im Isozitratdehydrogenase-1 (IDH1)-Gen. Der klinisch-prognostische Stellenwert dieser molekularen Marker steht dem der histologischen Subklassifizierung der anaplastischen Gliome nicht nach, sodass solche Markerprofile in zukünftige Klassifikationen Eingang finden sollten.
Die etablierten Behandlungsmethoden für die Primärtherapie anaplastischer Gliome sind Operation, Strahlentherapie und Chemotherapie mit Alkylanzien. Die aktuellen multinationalen Studienkonzepte wie CATNON versuchen, den kombinierten oder sequenziellen Einsatz von Strahlentherapie und Chemotherapie zu optimieren und der Studieneinschluss basiert nicht mehr auf der differenziellen Histologie der anaplastischen Gliome, sondern auf dem 1p/19q-Status. Parallel und ergänzend werden die beim Glioblastom zunehmend eingesetzten Hemmstoffe der Angiogenese zukünftig vermehrt auch zumindest im Rezidiv anaplastischer Gliome eingesetzt werden.
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Metadaten
Titel
Anaplastische Gliome
Neuropathologie, molekulare Diagnostik und aktuelle Studienkonzepte
verfasst von
Prof. Dr. W. Wick
M. Weller
Publikationsdatum
01.08.2010
Verlag
Springer-Verlag
Erschienen in
Der Nervenarzt / Ausgabe 8/2010
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-010-2956-1

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