Efficacy and safety of bevacizumab for the treatment of glioblastoma

Abstract

Abstract. Glioblastoma (GBM) is the most common and devastating primary malignant intracranial tumor in adults. The current first-line treatment for patients with newly diagnosed GBM is surgical resection followed by radiotherapy plus concomitant and adjuvant temozolomide. This treatment protocol may prolong the survival period of the patient, however it is not curative and more effective therapeutic strategies are required. GBM is a type of highly vascularized tumor with increased expression levels of vascular endothelial growth factor (VEGF), which is a significant mediator of angiogenesis. Since angiogenesis is essential for tumor growth, anti-angiogenic therapies hold potential for the treatment of GBM, and targeting VEGF has demonstrated promising results in previous studies. Bevacizumab (BEV) is a recombinant humanized monoclonal antibody that inhibits VEGF and is approved by the US Food and Drug Administration as a monotherapy treatment for patients with recurrent GBM and is associated with manageable toxicity. Previous studies have demonstrated that BEV may be an effective treatment for recurrent GBM, with prolonged progression-free survival and overall survival, and maintained patient quality of life and functional status. The present review article briefly outlines the mechanism of action of BEV and summarizes the current literature and clinical trial research on the role of BEV for the treatment of patients with recurrent and newly diagnosed

Analysis of angiogenesis related factors in glioblastoma, peritumoral tissue and their derived cancer stem cells

“…In addition, the interplay between tumor cells and ECs is a crucial event that results in the formation of new blood vessels, promoting tumor progression. The angiogenic dependency of GBM is strongly demonstrated by data from studies with angiogenesis inhibitors, mainly acting against VEGF/VEGFR [ 31 , 32 ]. The administration of Bevacizumab, an anti-VEGF monoclonal antibody, to GBM patients has been demonstrated to be effective in prolonging both progression-free survival and overall survival.…”

Utility of Glioblastoma Patient-Derived Orthotopic Xenografts in Drug Discovery and Personalized Therapy

“…Despite this therapeutic regimen, 95% of patients suffer from GBM relapse ( 19 ). Recurrent GBM patients are treated with the monoclonal antibody Bevacizumab (Avastin), an anti-angiogenic agent targeting VEGF ( 20 ). However, the overall survival remains very low, <10% at 5 years, with a median overall survival of merely 14.8 months ( 21 ).…”

Some features controlling the blood D-dimer level after resection of malignant brain glioma

“…Причиной РТТМ считается гиперэкспрессия метастатическими клетками фактора VEGF, попадающего с током крови в мелкие артериолы легких и вызывающего утолщение стенки последних и сужение их просвета с последующим образованием тромба, что, как многие полагают, и является причиной повышения D-димера крови [17]. Применительно к пациентам с ЗГ головного мозга сходный механизм тромбообразования, но уже в сосудах или прилежащих участках вещества мозга также возможен по причине высокой экспрес- сии вышеупомянутого фактора VEGF, но уже в клетках ГБ [18]. Окклюзия тромбом опухолевого сосуда в свою очередь может привести к формированию зон гипоксии в ложе резецированной ГБ и, как следствие, к радиорезистентности резидуальной ткани ГБ, а также к нарушению микроциркуляции в перитуморальной зоне, что у таких пациентов неизбежно приведет к снижению качества и продолжительности жизни.…”