from genetic sequencing to immunotherapy

brain tumors They are one of the most common solid neoplasms in adolescents and young adults, usually low-grade gliomas being the most common at this age. From 60 years old brain tumor The most common one is the one known as multiforme or high-grade glioblastoma, although we meet him at an early age, but less often. The doctor confirms this Sarah Christina Gonzalezfrom the Medical Oncology Service of the La Luz University Hospital in Madrid.

According to the expert, traditionally and diagnosis and treatment tumors of this type are call for medicine and in particular for oncology, due to their cerebral location, which makes their local access difficult due to the risk of neurological consequences, as well as the difficulty of reaching the central nervous system with classical chemotherapy treatment, since this is not possible. the drugs successfully overcome the blood-brain barrier (the brain’s natural defense that prevents toxic substances from entering the cerebral circulation from the blood).

“The low incidence of these tumors also makes progress in research difficult because large numbers of patients in clinical trials are needed to draw scientifically reliable conclusions,” emphasizes Dr. Sarah Cristina Gonzalez.

Today the oncologist continues: standard treatment For brain tumors, when location allows, surgery by a neurosurgeon followed by radiation therapy to the surgical site has been used, which has been shown to reduce the risk of local progression in the medium term.

Diagnosis and treatment

As the doctor describes, depending on the type of glioma (high or low grade or with certain molecular changes), it will be decided whether subsequent chemotherapy treatment needs to be continued or along with radiation therapy (one of the most effective treatments). drugs used) – temozolomide, although other, less common regimens are known, such as PCV, procarbazine-lomustine-vincristine).

“Today’s encouraging developments include improvements in diagnostics, driven largely by the ability to genetic sequencing of tumors with NGS (Next Generation Sequencing) platforms that allow us to know the genetic profile of a tumor and identify mutations that can allow us to carry out targeted treatments (as in the case of the BRAF mutation, especially relevant for these tumors), and also allows us to distinguish and correctly classify tumors in cases of difficult pathological diagnosis. Of course, NGS on these tumors will remain and will help us from all points of view (diagnosis, treatment and research),” says the doctor.

The specialist admits that in terms of treatment innovation, “we are seeing new clinical trials emerging in leading hospitals with immunotherapies, RNA vaccines and even innovative CAR-T cell therapy, which involves extracting lymphocytes from the patient’s body.” subsequently training them in the laboratory through genetic engineering to recognize tumor antigens, and then, once “trained,” reintroducing them into the patient so that these cells are the primary cells responsible for attacking the tumor and achieving a response,” he concludes.