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Tumor Discovery Choroid plexus tumors: Benign to malignant

Table 1. (Continued)
CPA CPP aCPP CPC
Clinical presentation Typically hydrocephalus. Ranges from headache, A combination of symptoms Similar to other CPTs because
hemifacial spasm or CSF caused by hydrocephalus of mechanical obstruction
rhinorrhea to hydrocephalus. and increased intracranial and mass effect.
pressure or neurological
symptoms caused by
mass effect. They include
headache, gait disturbances,
vertigo, diplopia, and
paresis.
Treatment Surgical resection. (i) Radiosurgery may be a Suggested approach is Most effective proposed
possible treatment option. maximal surgical resection. treatment is a combination
(ii) Definitive treatment is of surgical resection,
surgical resection with radiotherapy, and
adjuvant chemotherapy in chemotherapy.
some cases.
Abbreviations: aCPP: Atypical choroid plexus papilloma; CAM: Cell adhesion molecule; CPA: Choroid plexus adenoma; CPC: Choroid plexus
carcinoma; CPP: Choroid plexus papilloma; CT: Computerized tomography; DWI: Diffusion-weighted images; GFAP: Glial fibrillary acidic protein;
MRI: Magnetic resonance imaging; T1W1: Axial spin-echo T1-weighted images; T2W1: Axial fast spin-echo T2-weighted images.
the hypoxic microenvironment. These advantages can to sustain themselves and proliferate [125] . While current
subsequently increase the infiltration of immune cells, research on CPTs mainly focuses on their genetic and
improve the delivery of antitumor drugs, and boost the molecular characteristics, further investigation into their
generation of reactive oxygen species, respectively [112-116] . biomechanical mechanisms is warranted, as understanding
While the use of PTT to treat CPTs is scarce, many studies these aspects may further assist the development of
have investigated its efficacy on other brain tumors, such therapeutic and diagnostic techniques.
as glioblastomas, with recent advances in nanotechnology
further advancing its therapeutic potential [117,118] . Unlike 4.3.1. Peptide-based vaccines
gliomas, which have a higher incidence in more superficial Therapeutic cancer vaccines function by inducing systemic
structures of the brain, CPTs emerge deeper, posing a immunity against antigens overexpressed by tumor cells.
possible hurdle to be treated with PTT and LITT. Further Several studies have shown that cancer vaccines are
studies should focus on developing methods to deliver generally well tolerated in pediatric populations and
these modalities to deeper structures of the brain, perhaps provide preliminary evidence of immunological and
by means of intra-ventricular delivery [119] . modest clinical activity, albeit primarily on gliomas of
4.3. Immunotherapy and TME varying grades [126-128] . However, therapeutic vaccines are
only available through clinical trials and, as of the date
In terms of success rates, the efficacy of conventional of this review, ClinicalTrials.gov lists 1,446 studies in the
anticancer therapeutic approaches, such as chemotherapy, United States for the condition or disease of “Cancer,” 56
is limited by the non-specific toxicity and low specificity studies for “Brain Cancer,” and only 1 study for “Choroid
toward specific tumors [120] . Immunotherapy, on the other Plexus Tumors” [129] . One notable study, NCT00014573,
hand, is an emerging treatment option for cancer that includes CPTs among other brain cancers studied using
leverages a patient’s natural immunity or uses specific vaccine therapy as an adjuvant (partial resection of the
tumor biomarkers to avoid administering more broadly tumor, followed by chemotherapy and vaccine therapy,
toxic chemotherapeutic agents. The predominant followed by stem cell implantation with interleukin-2)
emerging forms of cancer immunotherapy to treat brain [130] . Although cancer vaccines have shown promise in
tumors include peptide-based vaccines, natural killer (NK) treating brain cancers such as CPTs, they have yet to
cell therapy, dendritic cell vaccines, immune checkpoint achieve their full potential as standalone cancer therapies.
inhibitors, and chimeric antigen receptor T cell (CAR-T) This limitation could be attributed to factors including the
therapy [121-124] . choice of tumor antigen, immune tolerance mechanisms,
Another promising avenue is the manipulation and the development of an immunosuppressive TME [131] .
of the TME, focusing on therapies that target the However, advances in nanomedicine may offer solutions to
surrounding cellular processes that cancerous cells utilize combat these limitations [132-137] .

Volume 2 Issue 2 (2023) 7 https://doi.org/10.36922/td.1057