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Treating Glioblastoma Mollecular Targets
Lecture notes from multiple sources for slides, references on slides
ABSTRACT
Primary brain tumors affect 12 per 100,000 individuals annually in the United States. There are approximately 29,000 primary brain tumors and 100,000 to 125,000 metastatic brain tumors. Although, brain tumors account for only 2% of cancer deaths they are responsible for 7% of years of life lost. The risk of brain cancer peaks at the age of two years old, declines, start to rise at 10 years old and then doubles after 40, continuing to rise until 70 years of age. Throughout the world the risk of malignant brain tumors are highest in males living in Israel, born in Europe or America; followed by those living in New Zealand, Sweden and Los Angeles. It is lowest in males from Osaka, Japan, Hawaii, Bombay, India or Miyagi Japan. For woman the highest incidence of malignant brain tumors are found in Israelis born in Israel followed by women living in Iceland, Sweden, new Zealand and lowest for those women living in Osaka, Japan, Miyagi, Japan and Bombay India. In the United States the risk is highest in Caucasian males. The standards of treatment have been with surgery possibly accompanied by radiation therapy and chemotherapy. Multiple studies since the late 1970s demonstrate that the average length of survival in weeks is approximately four weeks with no therapy, 19-24 weeks with chemotherapy, 36 weeks with radiation therapy, 53 weeks with surgical therapy; followed by a slightly better outcome with surgery, radiation and chemotherapy. Life expectancy is better in younger individuals, the extent of surgery, and the quality of life prior to surgical intervention. We do not know at this time the exact cause for primary brain tumors. There is a 15% family history of brain tumors. Brain tumors may be associated with occupations, food groups, medications, and viruses. Until we understand the etiology our treatment will be complex, incomplete and temporary.
The molecular nature of primary brain tumors has been studied with viral derived molecular probes. It is only the advances in biology, genetics, and immunology that will lead to an improved treatment. The process of tumor formation can be broken down into four different steps.
PRESENTATION
Initially a stimulus is presented to the astrocyte or other cell surface. This will stimulate the epidermal growth factor receptor or other growth factor receptors. The stimulus could be tissue growth factor alpha (TGF-a) or epidermal growth factor (EGR) or other molecules. Once the receptor is stimulated it is internalized and this (Continued on page 92)
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