Cellular mechanisms targeted during astrocytoma progression.

Astrocytomas are the commonest type of primary brain tumour. Four malignancy grades are recognized with very different prognosis. The most malignant and commonest form in adults is called glioblastoma and has a median survival with modern treatment of less than one year. Over the last 20 years, molecular genetic and cell biological data have helped identify some of the genes affected during oncogenesis and progression. This will be briefly reviewed. Many significant observations have been made but we are still far from understanding the neoplastic astrocyte at the molecular level. This is reflected in inconclusive attempts to date to use current molecular knowledge in providing additional prognostic information and in the design of molecular based treatments. However, it seems reasonable to assume that further understanding of oncogenesis and progression at the molecular level will provide a basis for improved clinical assessment and individually tailored treatment.