New Directions in Anti-Angiogenic Therapy for Glioblastoma

Neurotherapeutics. 2017 Apr;14(2):321-332. doi: 10.1007/s13311-016-0510-y.

Abstract

Anti-angiogenic therapy has become an important component in the treatment of many solid tumors given the importance of adequate blood supply for tumor growth and metastasis. Despite promising preclinical data and early clinical trials, anti-angiogenic agents have failed to show a survival benefit in randomized controlled trials of patients with glioblastoma. In particular, agents targeting vascular endothelial growth factor (VEGF) appear to prolong progression free survival, possibly improve quality of life, and decrease steroid usage, yet the trials to date have demonstrated no extension of overall survival. In order to improve duration of response and convey a survival benefit, additional research is still needed to explore alternative pro-angiogenic pathways, mechanisms of resistance, combination strategies, and biomarkers to predict therapeutic response.

Keywords: Angiogenesis; Bevacizumab; Glioblastoma; Glioma; VEGF.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Animals
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Bevacizumab / therapeutic use*
  • Biomarkers, Tumor
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / physiopathology
  • Clinical Trials as Topic
  • Drug Resistance, Neoplasm
  • Glioblastoma / drug therapy*
  • Glioblastoma / physiopathology
  • Humans
  • Neovascularization, Pathologic / drug therapy*
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents, Immunological
  • Biomarkers, Tumor
  • Vascular Endothelial Growth Factor A
  • Bevacizumab