THE primary brain tumors they record an overall incidence of approximately 25 new cases per 100 thousand inhabitants per year. Among these, the decidedly prevalent ones are: meningiomas, which in themselves represent 40% of the total of these tumors. Next are the gliomas – which originate from glial cells with functions of support and nutrition of neurons – which include the most aggressive form, the glioblastoma (which is actually a form of astrocytoma) which affects 14% of all primary tumors of the central nervous system. These are some of the numbers developed by Sin, la Italian neurology societyon the occasion of Brain Tumor Day which is celebrated on June 8th.
Sin takes stock of the situation on the new diagnostic and therapeutic horizons developed by scientific research. THE benign tumors, generally meningiomas, grow outside the brain tissue and do not infiltrate the tissue but can compress it. In these cases, radical surgery, if possible depending on the location of the neoplasm, is decisive. Tumors that grow inside the brain, most frequently i gliomascan instead be more or less aggressive depending on the histological and molecular biology characteristics.
Gliomas with greater aggressiveness, characterized by faster growth and a greater propensity to infiltrate the tissue, are striking generally the older populationwhile they are less frequent in patients under 50. The therapeutic protocols validated for the first phase of treatment include, when possible, surgical removalfollowed by patterns of radio and chemotherapy in combination or sequentially which, in less aggressive tumors, can also lead to survivals exceeding 20 years.
Glial tumors differ from each other on the basis of the type of cells from which they originate (astrocytes, oligodendroglial cells and ependymal cells) and on the degree of differentiation or malignancy. Humanitas explains that gliomas have traditionally been divided into low-grade tumors (low-grade glioma, LGG), more frequent between the ages of 20 and 40, or high-grade or malignant tumors (high-grade glioma, HGG), also called anaplastic gliomas, more frequent from 40 to 70 years. After the age of 70, glioblastoma multiforme is the most frequent and aggressive form.
More personalized and immunological therapies
«A big contribution in the diagnosis and prognosis of these pathologies – he comments Enrico Marchionihead of the Sin neuro-oncology study group – was provided from the last two classifications of the World Health Organization, in 2016 and 2021 respectively, which integrated the most recent acquisitions of molecular biology of primary brain tumors with the histological criteria traditionally used. The importance of this new classification model has a double value: it allows us to adopt personalized treatment strategies based on the use of “target” therapies, already in use for some years in general oncology and oncohematology, and allows the optimization of standard treatments also based on the biomolecular characteristics of brain tumors.” Alessandro Padovanipresident of the Italian Society of Neurology, adds that «thanks to progress in the field of molecular biology, it is probable that in the near future the therapeutic options, already more effective today than in the past, will further expand with the introduction of biological and immunological therapies with increasingly specific mechanisms of action and burdened with fewer side effects.”
Looking to the future therefore suggests that the fight against brain tumors could be much more favorable than it has been in the past, obtaining similar results to what is already underway for other forms of tumors. Tumors of the central nervous system (brain tumors are also defined in this way) are quite rare, he explains further Humanitas: in Italy they represent approximately1.6% of all cancers, with 6,100 new cases (Aiom-Airtum 2021), more frequent in males than females, and with a five-year survival from diagnosis of just over 25%. In Europe, on average, five cases of primary tumors of the central nervous system are diagnosed per 100,000 inhabitants per year, and they represent 2% of all cancer deaths.
