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Malignant brain tumors are among the most devastating types of cancer. Glioblastoma is the most common and serious form of brain cancer. Most glioblastomas are surgically unresectable and are typically diagnosed at an advanced stage. The high level of resistance to chemotherapy, radiotherapy and immunotherapy makes glioblastoma one of the most difficult cancers to treat. In brain tumors, the challenges of targeted therapy also include the blood-brain barrier, which often contributes to treatment failure. Therefore, developments of new treatment strategies are required. Metabolic treatments could be an alternative to conventional therapies. Metabolic approaches aim at suppressing glioblastoma tumorigenicity leading to glioblastoma cell death. Since cholesterol metabolism is deregulated in these tumors, this is a promising potential target for therapy. As glioblastoma cells draw on cholesterol from the central nervous system to survive, their growth is theoretically unlimited. Targeting the metabolism of cholesterol by different strategies using, among others, targets of LXRs (Liver X Receptors) or toxic cholesterol analogues could potentially oppose the growth of glial tumors. This chapter discusses the potential of targeting cholesterol metabolism using cholesterol derivatives as a pharmacological alternative to current therapeutic strategy.
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