Prognostic and predictive biomarkers in adult and pediatric gliomas: toward personalized treatment

Abstract

It is increasingly clear that both adult and pediatric glial tumor entities represent collections of neoplastic lesions, each with individual pathological molecular events and treatment responses. In this review, we discuss the current prognostic biomarkers validated for clinical use or with future clinical validity for gliomas. Accurate prognostication is crucial for managing patients as treatments may be associated with high morbidity and the benefits of high risk interventions must be judged by the treating clinicians. We also review biomarkers with predictive validity, which may become clinically relevant with the development of targeted therapies for adult and pediatric gliomas.

Keywords: gliomas; predictive biomarkers; prognostic biomarkers.

Figure 1

Key signaling pathways in the tumorigenesis of gliomas. The biological behavior of glial tumors is traditionally based on histological typing and grading. Histology is increasingly being supplemented using molecular information on genes, epigenetic markers, transcriptional regulators, and complex gene signatures. This multitude of events converges on a number of common signaling pathways with considerable cross talk. Increased understanding of these pathways and their interactions is facilitating a biomarker-driven approach to glial tumor biology – improving diagnosis, prognostic estimation, and the development of targeted therapies.