Treatment for brain tumor does not always follow recom...( arch involving malignant gliomas. Wider...),Health

arch involving malignant gliomas. Wider availability of novel approaches and increased cooperation between academic institutions and community centers must occur to improve care patterns for patients with malignant glioma. In addition, for any clinical trial, correlative biological studies of tumor specimens need to be wedded to the trial, particularly when end points may be biological change rather than tumor reduction demonstrated on MRI. As oncology takes on increasingly specific, targeted approaches, it is inappropriate to continue rolling out new therapies indiscriminately and often conclude that they are not effective in 'malignant gliomas,' a molecularly heterogeneous group of tumors lumped together based on light microscopy. Some treatments may be highly beneficial to a select few patients, yet ineffective in many others. At the same time, phase 1 trials in oncology that have traditionally excluded patients with brain tumors should be made more widely available to those with malignant glioma ," the editorialists write.

"There are few proven risk factors for the development of brain tumors. It is difficult to imagine advancing cures unless the genetic, environmental, dietary, other risk factors, and their interactions that cause brain tumors are more clearly established. Biological studies need to be incorporated into these epidemiologic investigations to enhance the informativeness of these studies. Increased funding via governmental grant mechanisms or philanthropic foundations will be paramount for the progress needed to achieve this progress. Advancements for patients with malignant glioma have been negligible, and there is a real risk of going nowhere by simply continuing to travel the same path," they conclude.

(JAMA. 2005;293:615-617. Available post-embargo at JAMA.com)

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Contact: Carol Hyman
415-476-2557
JAMA and Archives Journals
1-Feb-2005

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