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Oncolytic Viruses in Supratentorial Neoplasms Treatment

Introduction to Supratentorial Neoplasms

Supratentorial neoplasms (STT) refers to primary and metastatic (secondary) tumors of the brain located above the tentorium cerebelli, which is an extension of the dura mater separating the brain into the infratentorium and the supratentorium. In adults, the most common STT includes astrocytoma, oligodendrogliomas, and ependymomas. Astrocytoma, the most common adult CNS tumor, arises from the glial cells in the CNS. They include a wide spectrum of low-grade to high-grade tumors. Ependymomas (grade I to III) can develop at any age, although they are most common in childhood, typically developing in the lining of the ventricles. Metastases and meningiomas are 2 other groups of brain tumors that commonly reside within the boundaries of the supratentorium. Common symptoms of STT include seizures, aphasia, hemianopsia, hemiparesis, and sensory deficits. However, clinical manifestations vary with the location of the lesion. Conventionally, STTs are diagnosed with CT and MRI by depicting their imaging characteristics and location. Recently, advanced neuroimaging has been used for STT diagnosis as it could provide additional information by determining the metabolism and physiology of these lesions.

Treatment for Supratentorial Neoplasms

Currently, the standard treatment of STT is surgery, to remove the tumor, followed by chemotherapy and radiotherapy. However, the resection is not always easy due to the localization and characteristics of these tumors. Moreover, treatments with chemotherapeutic agents and radiation therapy not only affect cancer cells but also normal cells, producing high toxicity and, sometimes, severe sequelae after including neurological, endocrine, and neurosensory impairments. Furthermore, many patients develop chemoresistance which significantly reduces their survival. For these reasons, there is an urgent need for new therapies that could decrease the toxicity and improve the survival rates in STTs. Oncolytic viruses represent a potential therapy for several tumors, including STTs, due to their capacity to target cancer stem cells (CSC) which are, in theory, the cells responsible for tumor growth.

Schematic representation of “suicide gene therapy” using adenoviral vector and retroviral vector in GBM cells. Fig.1 Schematic representation of “suicide gene therapy” using adenoviral vector and retroviral vector in GBM cells. (Manikandan, 2019)

Oncolytic Viral Therapy for Supratentorial Neoplasms

Several types of viruses have been studied as a possible treatment for brain tumors in childhood. Some of these viruses have a natural tropism for tumor cells, and others have been attenuated to improve the safety or they have been genetically modified to render them tumor-specific.

Reference

  1. Manikandan, C.; et al. Viral vector: potential therapeutic for glioblastoma multiforme. Cancer Gene Therapy. 2019, pp.1-10.

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