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2018 ; 70
(3
): 412-445
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Current Challenges and Opportunities in Treating Glioblastoma
#MMPMID29669750
Shergalis A
; Bankhead A 3rd
; Luesakul U
; Muangsin N
; Neamati N
Pharmacol Rev
2018[Jul]; 70
(3
): 412-445
PMID29669750
show ga
Glioblastoma multiforme (GBM), the most common and aggressive primary brain
tumor, has a high mortality rate despite extensive efforts to develop new
treatments. GBM exhibits both intra- and intertumor heterogeneity, lending to
resistance and eventual tumor recurrence. Large-scale genomic and proteomic
analysis of GBM tumors has uncovered potential drug targets. Effective and
"druggable" targets must be validated to embark on a robust medicinal chemistry
campaign culminating in the discovery of clinical candidates. Here, we review
recent developments in GBM drug discovery and delivery. To identify GBM drug
targets, we performed extensive bioinformatics analysis using data from The
Cancer Genome Atlas project. We discovered 20 genes, BOC, CLEC4GP1, ELOVL6, EREG,
ESR2, FDCSP, FURIN, FUT8-AS1, GZMB, IRX3, LITAF, NDEL1, NKX3-1, PODNL1, PTPRN,
QSOX1, SEMA4F, TH, VEGFC, and C20orf166AS1 that are overexpressed in a
subpopulation of GBM patients and correlate with poor survival outcomes.
Importantly, nine of these genes exhibit higher expression in GBM versus
low-grade glioma and may be involved in disease progression. In this review, we
discuss these proteins in the context of GBM disease progression. We also
conducted computational multi-parameter optimization to assess the blood-brain
barrier (BBB) permeability of small molecules in clinical trials for GBM
treatment. Drug delivery in the context of GBM is particularly challenging
because the BBB hinders small molecule transport. Therefore, we discuss novel
drug delivery methods, including nanoparticles and prodrugs. Given the aggressive
nature of GBM and the complexity of targeting the central nervous system,
effective treatment options are a major unmet medical need. Identification and
validation of biomarkers and drug targets associated with GBM disease progression
present an exciting opportunity to improve treatment of this devastating disease.