Antiangiogenic therapy in malignant gliomas.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
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.
Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. anorden@partners.org
Andrew D
AD
Norden
Jan
J
Drappatz
Patrick Y
PY
Wen
D020533:Angiogenesis Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000378:metabolism; D001932:Brain Neoplasms / Q000188:drug therapy*; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D000077146:Irinotecan; D009362:Neoplasm Metastasis; D011788:Quality of Life; D015398:Signal Transduction; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D036341:Intercellular Signaling Peptides and Proteins; D042461:Vascular Endothelial Growth Factor A; D000077146:Irinotecan; D002166:Camptothecin