NUEVAS TERAPIAS EN EL MANEJO DE LOS GLIOMAS DE ALTO GRADO

The challenge of improving the current treatment of high-grade gliomas has been approached with great creativity generating many diverse strategies. An interim analysis of a phase III trial showed improved results of standard therapy when complemented with alternating electric fields therapy (Novo TTF-100 A); the true magnitude and clinical relevance of this benefit still remains to be determined because of the nature and limitations of interim analyses. The alleged benefit of antiviral treatment against cytomegalovirus is highly controversial and has not been irrefutably proven. Anti-angiogenic therapy has demonstrated utility in the recurrent setting, at least as a symptomatic treatment; in de novo patients no increase in survival has been proven. Targeted Therapy against growth signals, a very appealing concept, has not yet been successful in clinical trials. Anti-tumor vaccines and immunomodulation with checkpoint inhibitors have shown preliminary encouraging results, the same is true about therapy with oncolytic viruses. Gene therapy for this purpose seems to be still in its early stages of development and it will probably take longer before successful clinical application.