Kumar Sanath, Arbab Ali S
Radiation Oncology, Henry Ford Hospital, Detroit, MI-48202.
Cellular and Molecular Imaging Laboratory, Radiology, Henry Ford Hospital ; Radiology, Wayne State University School of Medicine, Detroit, MI.
Zhong Liu Za Zhi. 2013 Aug 18;1(3):16-19.
Glioblastoma (GBM) is the most common malignant primary brain tumor in adults. However, the survival of patients with GBM has been dismal after multi-disciplinary treatment with surgery, radiotherapy, and chemotherapy. In the efforts to improve clinical outcome, anti-angiogenic therapy with bevacizumab (Avastin) was introduced to inhibit vascular endothelial growth factor (VEGF) mediated tumor neovascularization. Unfortunately, the results from clinical trials have not lived up to the initial expectations. Patients either fail to respond to anti-angiogenic therapy or develop resistance following an initial response. The failure of anti-angiogenic therapy has led to a frustration among physicians and research community. Recent evidence indicates that the dogma of tumor neovascularization solely dependent on VEGF pathway to be overly simplistic. A realistic model of tumor neovascularization should include alternative pathways that are independent of VEGF signaling. A better understanding of the underlying processes in tumor neovascularization would help in designing successful anti-angiogenic treatment strategies.
胶质母细胞瘤（GBM）是成人中最常见的原发性恶性脑肿瘤。然而，胶质母细胞瘤患者在接受手术、放疗和化疗的多学科治疗后的生存率一直很低。为了改善临床结果，引入了贝伐单抗（阿瓦斯汀）抗血管生成疗法，以抑制血管内皮生长因子（VEGF）介导的肿瘤新生血管形成。不幸的是，临床试验结果并未达到最初的预期。患者要么对抗血管生成疗法无反应，要么在初始反应后产生耐药性。抗血管生成疗法的失败导致医生和研究界感到沮丧。最近的证据表明，仅依赖VEGF途径的肿瘤新生血管形成教条过于简单。一个现实的肿瘤新生血管形成模型应该包括独立于VEGF信号传导的替代途径。更好地理解肿瘤新生血管形成的潜在过程将有助于设计成功的抗血管生成治疗策略。
