Genetic expression profiles of adult and pediatric ependymomas: molecular pathways, prognostic indicators, and therapeutic targets

Clin Neurol Neurosurg. 2013 Apr;115(4):388-99. doi: 10.1016/j.clineuro.2012.12.006. Epub 2013 Jan 29.

Abstract

Ependymomas are tumors that can present within either the intracranial or spinal regions. While 90% of all pediatric ependymomas are intracranial, spinal cord ependymomas are more commonly found in patients 20-40 years old. Treatment for spinal lesions has achieved local control rates up to 100% following gross total resection, while pediatric intracranial tumors have 40-60% mortality. Given the inability to effectively treat ependymomas with current standard practices, researchers have focused their efforts on evaluating chromosomal alterations, genetic expression profiles, epigenetic events, and molecular pathways. While these studies have provided critical insight into the potential mechanisms underlying ependymoma pathogenesis, understanding of the intricate interplay between the various pathways involved in tumor initiation, development, and progression will require deeper investigation. However, several potential prognostic markers and therapeutic targets have been identified, providing key areas of focus for future research. The utilization of unique genetic expression profiles based upon patient age, tumor location, tumor grade, and subtype has revealed a multitude of findings warranting further study. Inspection of various molecular pathways associated with ependymomas may establish the foundation for developing novel therapies capable of achieving significant clinical improvements with individualized regimens specifically designed for personalized treatment strategies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use
  • Brain Neoplasms / genetics
  • Brain Neoplasms / therapy
  • Central Nervous System Neoplasms / genetics*
  • Central Nervous System Neoplasms / therapy*
  • Child
  • DNA Fingerprinting
  • Ependymoma / genetics*
  • Ependymoma / therapy*
  • Gene Expression Regulation, Neoplastic / genetics
  • Humans
  • Metabolic Networks and Pathways
  • Prognosis
  • Spinal Neoplasms / genetics
  • Spinal Neoplasms / therapy

Substances

  • Antineoplastic Agents