Antiangiogenic drugs are increasingly used in malignant glioma therapy. This article reviews the rationale for targeting angiogenesis in malignant gliomas, summarizes relevant clinical trial results, and discusses promising avenues of investigation in antiangiogenic therapy.
Combination therapy with bevacizumab, the humanized monoclonal antibody against vascular endothelial growth factor, and irinotecan has emerged as the treatment of choice for recurrent malignant gliomas, prolonging progression-free survival markedly in comparison with historical controls. Several small molecule tyrosine kinase inhibitors of the vascular endothelial growth factor receptor are under investigation and show promise as well.
Antiangiogenic treatments are effective and well tolerated options for recurrent malignant glioma. Future studies will determine whether these drugs have a role in first line therapy. Studies are in progress to elucidate mechanisms of resistance and suggest approaches to further improve survival in patients with these challenging tumors.
aDivision of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, USA
bCenter for Neuro-Oncology, Department of Medical Oncology, Dana-Farber/Brigham and Women's Cancer Center, USA
cHarvard Medical School, Boston, Massachusetts, USA
Correspondence to Andrew D. Norden, Center for Neuro-Oncology, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA Tel: +1 617 632 2166; fax: +1 617 632 4773; e-mail: email@example.com