Daekin University, Geelong Hospital, Andrew Love Cancer Centre, School of Medicine, 70 Swanston Street, Geelong VIC 3220, Australia.
Expert Opin Biol Ther. 2012 Aug;12(8):1101-11. doi: 10.1517/14712598.2012.694422. Epub 2012 Jun 5.
Gliomas are highly vascular and rich in vascular endothelial growth factor (VEGF) that promotes angiogenesis. Bevacizumab is a monoclonal antibody against VEGF inhibiting angiogenesis by preventing receptor activation. Phase II clinical trials using bevacizumab in both newly diagnosed and recurrent high-grade glioma (HGG) showed promising results.
This is a review of clinical trials investigating bevacizumab in newly diagnosed and recurrent HGGs with a focus on outcome results. A future perspective about the expected role of bevacizumab is given. Bevacizumab efficacy, safety and tolerability, the combination of radiation and bevacizumab as well as the use of bevacizumab to treat pseudoprogression are discussed. Further criteria of response evaluation needed to be adjusted in the age of anti-angiogenic therapy and this will be discussed.
Bevacizumab has been shown to be safe and tolerable in HGG. In the recurrent disease setting, bevacizumab alone might be sufficient for a clinical benefit and is currently approved as a single agent for this indication. While clinical trials demonstrate a prolonged progression-free survival in bevacizumab-treated HGG, a benefit on OS has not been demonstrated yet. Bevacizumab has also been introduced into other settings in neuro-oncology including concurrent administration with re-irradiation for recurrent HGG.
神经胶质瘤血管丰富，富含血管内皮生长因子（VEGF），可促进血管生成。贝伐单抗是一种针对 VEGF 的单克隆抗体，通过阻止受体激活来抑制血管生成。在新诊断和复发性高级别神经胶质瘤（HGG）中使用贝伐单抗的 II 期临床试验显示出有希望的结果。
本文回顾了研究贝伐单抗在新诊断和复发性 HGG 中的临床试验，重点关注结果。对贝伐单抗的预期作用进行了未来展望。讨论了贝伐单抗的疗效、安全性和耐受性、放疗联合贝伐单抗以及贝伐单抗治疗假性进展的作用。在抗血管生成治疗时代，需要调整反应评估的进一步标准，这将在本文中进行讨论。
贝伐单抗在 HGG 中的安全性和耐受性已得到证实。在复发性疾病中，贝伐单抗单独使用可能足以获得临床获益，目前已被批准作为单一药物用于该适应证。虽然临床试验显示贝伐单抗治疗的 HGG 无进展生存期延长，但尚未证明其总生存期获益。贝伐单抗也已被引入神经肿瘤学的其他领域，包括与复发性 HGG 的再放疗联合使用。
