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Review
. 2023 Dec 15;23(24):9842.
doi: 10.3390/s23249842.

Advances in Diagnostic Tools and Therapeutic Approaches for Gliomas: A Comprehensive Review

Affiliations
Review

Advances in Diagnostic Tools and Therapeutic Approaches for Gliomas: A Comprehensive Review

Gayathree Thenuwara et al. Sensors (Basel). .

Abstract

Gliomas, a prevalent category of primary malignant brain tumors, pose formidable clinical challenges due to their invasive nature and limited treatment options. The current therapeutic landscape for gliomas is constrained by a "one-size-fits-all" paradigm, significantly restricting treatment efficacy. Despite the implementation of multimodal therapeutic strategies, survival rates remain disheartening. The conventional treatment approach, involving surgical resection, radiation, and chemotherapy, grapples with substantial limitations, particularly in addressing the invasive nature of gliomas. Conventional diagnostic tools, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), play pivotal roles in outlining tumor characteristics. However, they face limitations, such as poor biological specificity and challenges in distinguishing active tumor regions. The ongoing development of diagnostic tools and therapeutic approaches represents a multifaceted and promising frontier in the battle against this challenging brain tumor. The aim of this comprehensive review is to address recent advances in diagnostic tools and therapeutic approaches for gliomas. These innovations aim to minimize invasiveness while enabling the precise, multimodal targeting of localized gliomas. Researchers are actively developing new diagnostic tools, such as colorimetric techniques, electrochemical biosensors, optical coherence tomography, reflectometric interference spectroscopy, surface-enhanced Raman spectroscopy, and optical biosensors. These tools aim to regulate tumor progression and develop precise treatment methods for gliomas. Recent technological advancements, coupled with bioelectronic sensors, open avenues for new therapeutic modalities, minimizing invasiveness and enabling multimodal targeting with unprecedented precision. The next generation of multimodal therapeutic strategies holds potential for precision medicine, aiding the early detection and effective management of solid brain tumors. These innovations offer promise in adopting precision medicine methodologies, enabling early disease detection, and improving solid brain tumor management. This review comprehensively recognizes the critical role of pioneering therapeutic interventions, holding significant potential to revolutionize brain tumor therapeutics.

Keywords: brain tumor therapeutics; diagnostic tools; gliomas; multimodal therapeutic strategies; precision medicine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Challenges in glioma research, such as drug accessibility, lack of reliable biomarkers, recurrent resistance of the treatment, progression vs. pseudoprogression, and intertumoral and intratumoral heterogeneity (created with the free trail of BioRender).
Figure 2
Figure 2
Geographical distribution of glioblastoma clinical trials.
Figure 3
Figure 3
Scheme of the glioma tumor microenvironment and biomarkers. (a) Tumor-associated macrophages, regular T cells, monocytes, neutrophils, neurons, pericytes, glioma cells, inflammatory cytokines, astrocytes, extracellular vesicles, blood vessels, dendric cells, and NK cells are present in the glioma tumor microenvironment. (b) The biomarkers are B7-H3, CD70, CD147, CAIX, CSPG4, GD2, EGFRVIII, HER2, IL13Rα2, MMP2, and TROP2 (created with the free trail of BioRender).
Figure 4
Figure 4
Nanomaterial-based targeting for glioma therapy with emphasis on overcoming the blood–brain barrier: the cutting-edge utilization of nanomaterials in the context of precision targeting and therapeutic interventions for gliomas (created with the free trail of BioRender).
Figure 5
Figure 5
Elucidating the mechanisms of Fc gamma chimeric receptor cell-mediated (Fcγ-CRs T) eradication of tumor cells: the Fc fragment of monoclonal antibodies (mAb) binding to Fcγ-CRs to Fcγ-CR T cells. In response to the identification of glioma-associated antigens and the subsequent binding of monoclonal antibodies (mAb) to Fcγ-CRs T cells, the activation of Fcγ-CRs T cells ensues, resulting in the initiation of cell-mediated cytotoxicity through the release of cytotoxic granules or the activation of FAS expression dependent on Fcγ-CRs (created with the free trail of BioRender).
Figure 6
Figure 6
Multimodal stimulation of nanoparticles with an engrafted microchip for the controlled release of diverse therapeutic agents in the context of glioma therapy The versatile activation of nanoparticles to enable the controlled discharge of various therapeutic agents, including chemotherapeutic agents, viral vectors carrying inhibitory genes, Fcγ-CR T cells for targeted drug delivery, transfection of glioma cells, and the selective expression of ion channels. Integration of inhibitory gene circuits within glioma cells responsive to light, heat, or mechanical forces (created with the free trail of BioRender).

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