Gliomas: advances in molecular analysis and characterization

Background: Gliomas represent the most common primary brain tumor. Despite recent advances in diagnostic imaging, neurosurgical technique, radiation therapy, and chemotherapy, significant advances in accurate prognosis and improved survival have not been achieved. Nevertheless, new developments in molecular biology could have potential impact on the clinical management of patients with these brain tumors. This review will describe the technological advances being used to enrich the classification of gliomas, present specific studies that have successfully used the new technologies to identify molecular subtypes of glioblastoma, and discuss the implications of such enhanced classification and molecular characterizations for the prediction of therapeutic response and the design of future brain tumor therapies. Results: Innovative techniques using complementary DNA and oligonucleotide microarrays (gene chips), tissue microarrays (tissue chips), and differential inummoabsorption have provided high throughput and potentially comprehensive approaches for the molecular characterization of human gliomas. Alterations of several tumor suppressor genes and oncogenes have already been identified as being critical to glioma transformation and progression. These approaches have led to the subclassification of glioblastoma multiforme into distinct subtypes based on the molecular signatures of the tumors. Conclusions: Classifications of gliomas can now be enhanced with new techniques for comprehensive molecular characterization. Improved and efficient molecular profiling of brain tumors is advancing diagnosis/prognosis and identifying targets for novel and rational therapeutic approaches. Neurosurgeons and neuro-oncologists should be aware of these new developments so they can better advise and treat their patients. (c) 2005 Elsevier Inc. All rights reserved.