Differences Between Pediatric and Adult Malignant Astrocytomas
Differences Between Pediatric and Adult Malignant Astrocytomas
As the name implies, GBM can take on a number of different appearances. Many of these different 'subtypes' of GBM are now thought to be mediated by the activation of particular pathways that drive the tumors towards certain phenotypes, for example proneuronal versus mesenchymal. Not surprisingly, similar heterogeneity in pediatric GBM suggests that, as in adults, these tumors can develop through activation of a number of different aberrant signaling pathways. The important implication of these findings are the need to consider the unique characteristics of each tumor, adult or pediatric, in the development of active treatment strategies. While some grouping of cases will be necessary to run clinical trials for the immediate future, we are rapidly reaching the era of true personalized medicine, where each patient and each tumor is treated based on the individual characteristics of that particular patient. The heterogeneity reflected in GBM discussed above is also observed in lower-grade gliomas, both between children and adults, and even within different age groups and associated factors (e.g., NF1) in children, suggesting that these principles will be true for other pediatric gliomas, and likely the majority of cancers in general.
Future Perspective
As the name implies, GBM can take on a number of different appearances. Many of these different 'subtypes' of GBM are now thought to be mediated by the activation of particular pathways that drive the tumors towards certain phenotypes, for example proneuronal versus mesenchymal. Not surprisingly, similar heterogeneity in pediatric GBM suggests that, as in adults, these tumors can develop through activation of a number of different aberrant signaling pathways. The important implication of these findings are the need to consider the unique characteristics of each tumor, adult or pediatric, in the development of active treatment strategies. While some grouping of cases will be necessary to run clinical trials for the immediate future, we are rapidly reaching the era of true personalized medicine, where each patient and each tumor is treated based on the individual characteristics of that particular patient. The heterogeneity reflected in GBM discussed above is also observed in lower-grade gliomas, both between children and adults, and even within different age groups and associated factors (e.g., NF1) in children, suggesting that these principles will be true for other pediatric gliomas, and likely the majority of cancers in general.