ABSTRACT
Operative procedures, improved precision of irradiation, and adjuvant chemotherapy have slightly improved the survival of glioma patients in the past decades. A significant step ahead has not yet been accomplished. The reason for this failure is due to the biology of malignant gliomas. Deep infiltration of healthy and neurologically vulnerable brain structures prevents total tumor resection; there is inherent resistance to the radiotherapy and chemotherapy that can be safely applied to the brain. Given the major steps that have been made in the last years in the understanding of genetic and cell biologic mechanisms that are involved in the initiation and progression of gliomas, this clearer understanding should be translated into approaches targeting the key molecular effectors of glioma malignancy. These novel therapeutic strategies are based on new pharmaceutical compounds that are designed to interfere with specific targets in glioma signal transduction pathways or focus on gene therapy to modify the tumor microenvironment. This chapter deals with preclinical or clinical stage developments in glioma therapy. Specifically, the novel tyrosine kinase inhibitors measures to influence motility and angiogensis, proapoptotic strategies, and immunotherapy are discussed. It finishes with an outlook on glioma-initiating cells and cellular vectors as novel vehicles for glioma therapy.
