Department of Neurology, University of California, UCLA Department of Neurology, Neuro-Oncology Program, Los Angeles, CA 90024, USA.
Future Oncol. 2012 Aug;8(8):929-38. doi: 10.2217/fon.12.81.
Bevacizumab is a monoclonal antibody that binds and neutralizes VEGF. Bevacizumab is currently indicated as monotherapy for recurrent glioblastoma. Recent data from Phase II trials of bevacizumab as first-line therapy for glioblastoma have been promising, and have led to two Phase III trials evaluating the use of bevacizumab as first-line therapy when combined with radiation and temozolomide. Potential complications relating to interpretation of the results of these Phase III studies include the crossover use of bevacizumab upon recurrence in the placebo arm. Recently published single-arm evaluations of adding bevacizumab to standard first-line therapy in glioblastoma multiforme have shown an improvement in progression-free survival and overall survival when compared with historical controls obtained prior to widespread use of bevacizumab in recurrent glioblastoma multiforme. When these data are compared with more contemporary studies from the bevacizumab era, the improvement in progression-free survival seems to be maintained but the impact on overall survival with first-line bevacizumab therapy seems less clear. Bevacizumab therapy alters the imaging characteristics of glioblastoma, and new criteria have been established to assess treatment response and progression in the setting of widespread bevacizumab use.
贝伐珠单抗是一种单克隆抗体，可与 VEGF 结合并中和 VEGF。贝伐珠单抗目前被批准用于复发性胶质母细胞瘤的单药治疗。贝伐珠单抗作为胶质母细胞瘤一线治疗的 II 期临床试验的最新数据令人鼓舞，并促成了两项 III 期试验，评估了贝伐珠单抗与放疗和替莫唑胺联合作为一线治疗的应用。与这些 III 期研究结果解释相关的潜在并发症包括在安慰剂组中复发时交叉使用贝伐珠单抗。最近发表的关于在标准一线治疗中添加贝伐珠单抗治疗多形性胶质母细胞瘤的单臂评估显示，与贝伐珠单抗在复发性多形性胶质母细胞瘤中广泛使用之前获得的历史对照相比，无进展生存期和总生存期得到改善。当将这些数据与贝伐珠单抗时代的更现代的研究进行比较时，无进展生存期的改善似乎得到维持，但一线贝伐珠单抗治疗对总生存期的影响似乎不太清楚。贝伐珠单抗治疗改变了胶质母细胞瘤的影像学特征，已经建立了新的标准来评估广泛使用贝伐珠单抗时的治疗反应和进展。
