Bevacizumab for the treatment of glioblastoma

    Authors

    S. Chowdhary;M. Chamberlain

    Comments

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    Abbreviated Journal Title

    Expert Rev. Neurother.

    Keywords

    anti-angiogenesis; bevacizumab; glioblastoma; high-grade glioma; MGMT; VEGF; ENDOTHELIAL GROWTH-FACTOR; NEWLY-DIAGNOSED GLIOBLASTOMA; RECURRENT; MALIGNANT GLIOMA; HIGH-GRADE GLIOMAS; METASTATIC COLORECTAL-CANCER; PHASE-II TRIAL; PROMOTER METHYLATION STATUS; SINGLE-AGENT BEVACIZUMAB; BRAIN-TUMOR CONSORTIUM; PLUS IRINOTECAN; Clinical Neurology; Pharmacology & Pharmacy

    Abstract

    Glioblastoma (GB) is the most common adult malignant primary brain tumor that arises from glial precursor cells. Survival in GB is variable ranging from 6 to 20 months notwithstanding current standard of care (SOC) treatment. Therapy has improved, but nonetheless GB is still invariably recurrent and incurable. Treatment options at recurrence include re-operation with or without carmustine (BCNU) wafer implantation (Gliadel), re-irradiation and standard/experimental chemo- or targeted therapy. Recurrent GB radiographic response rates to cytotoxic chemotherapy are less than 10% and median 6-month progression-free survival (PFS6) is 15%. With the recognition of the importance of tumor angiogenesis and the development of targeted therapy based on angiogenic inhibition, two pivotal trials of the VEGF-directed monoclonal antibody, bevacizumab (BEV, Avastin), were conducted in recurrent GB. Based upon the results of these two prospective US trials (median radiographic response rate: 25%; PFS6: 40%), BEV as a single agent was granted accelerated approval in the USA for recurrent GB. This review is a summary of current literature and clinical trials research in the role of BEV for the treatment of newly diagnosed and recurrent GB and potential future use of anti-angiogenic therapies in the management of GB.

    Journal Title

    Expert Review of Neurotherapeutics

    Volume

    13

    Issue/Number

    8

    Publication Date

    1-1-2013

    Document Type

    Review

    Language

    English

    First Page

    937

    Last Page

    949

    WOS Identifier

    WOS:000323539300010

    ISSN

    1473-7175

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