Precision Population Cancer Medicine in Brain Tumors: A Potential Roadmap to Improve Outcomes and Strategize the Steps to Bring Interdisciplinary Interventions.
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Brain tumors, a significant health burden, rank as the second leading cause of cancer among adolescents and young adults and the eighth most common cancer in older adults. Despite treatment advances, outcomes for many brain tumor types, especially glioblastoma multiforme (GBM), remain poor. Precision population cancer medicine (PPCM) offers promising avenues for improving outcomes in brain tumor management. This comprehensive review delves into the current landscape of brain tumor diagnosis and treatment, with a primary focus on the potential of PPCM to enhance care. The review explores several key areas where PPCM approaches show promise. In genetics and molecular biology, the genetic heterogeneity of brain tumors poses challenges and opportunities for targeted therapies. Understanding genetic patterns can guide treatment strategies and improve prognostication. Epigenetic modifications are crucial in brain tumor development and progression. Deoxyribonucleic acid (DNA) methylation patterns, particularly of the O6-methylguanine-DNA methyltransferase (MGMT) gene promoter, serve as essential biomarkers for treatment response and prognosis in GBM. Targeting epigenetic mechanisms could lead to novel therapeutic approaches. Non-invasive liquid biopsy techniques show potential for diagnosis, monitoring, and prognostication in brain tumors. Analysis of circulating tumor DNA and microRNAs may provide valuable information about tumor characteristics and treatment response. Advanced imaging techniques, including radiomics and radiogenomics, combined with artificial intelligence (AI) algorithms, are enhancing tumor detection, characterization, and treatment planning. These technologies can contribute to more personalized treatment approaches. In addition, emerging nanotherapeutic platforms, which involve the use of nanoparticles to deliver drugs directly to tumors, and theranostic approaches, which combine therapy and diagnostics in a single platform, offer new possibilities for targeted drug delivery and real-time treatment monitoring in brain tumors. The review also addresses socioeconomic and demographic factors influencing brain tumor incidence and outcomes. It highlights the stark disparities in care access and survival rates among different racial and ethnic groups, emphasizing the urgent need for PPCM strategies to address these inequities. Challenges in implementing PPCM for brain tumors include the blood-brain barrier, which limits drug delivery, and the need for more extensive clinical trials to validate new approaches. The authors stress the importance of interdisciplinary collaboration and data sharing to advance the field, making the audience feel united and part of a larger team. While PPCM holds great promise, the review emphasizes that it should complement, not replace, population-level interventions and standard-of-care treatments. The authors advocate for a balanced approach that leverages cutting-edge personalized strategies while ensuring broad access to effective treatments. In conclusion, PPCM represents a powerful tool in the fight against brain tumors, offering the potential for more targeted, effective, and less toxic treatments. However, realizing its full potential will require ongoing research, clinical validation, and policy interactions to address disparities in care access.