Angiogenesis in brain tumours.
Despite aggressive surgery, radiotherapy and chemotherapy, malignant gliomas remain uniformly fatal. To progress, these tumours stimulate the formation of new blood vessels through processes driven primarily by vascular endothelial growth factor (VEGF). However, the resulting vessels are structurally and functionally abnormal, and contribute to a hostile microenvironment (low oxygen tension and high interstitial fluid pressure) that selects for a more malignant phenotype with increased morbidity and mortality. Emerging preclinical and clinical data indicate that anti-VEGF therapies are potentially effective in glioblastoma--the most frequent primary brain tumour--and can transiently normalize tumour vessels. This creates a window of opportunity for optimally combining chemotherapeutics and radiation.
Jain
Rakesh K
RK
Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, 100 Blossom Street, Boston, Massachusetts 02114, USA. jain@steele.mgh.harvard.edu
di Tomaso
Emmanuelle
E
Duda
Dan G
DG
Loeffler
Jay S
JS
Sorensen
A Gregory
AG
Batchelor
Tracy T
TT
D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001808:Blood Vessels / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D001929:Brain Edema / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D001932:Brain Neoplasms / Q000098:blood supply* / Q000188:drug therapy / Q000503:physiopathology*; D005909:Glioblastoma / Q000098:blood supply / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D009389:Neovascularization, Pathologic / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000378:metabolism
D000970:Antineoplastic Agents; D042461:Vascular Endothelial Growth Factor A