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抗血管生成药物:在胶质母细胞瘤治疗中的作用。

Anti-Angiogenics: Their Role in the Treatment of Glioblastoma.

出版信息

Oncol Res Treat. 2018;41(4):181-186. doi: 10.1159/000488258. Epub 2018 Mar 23.

Abstract

Angiogenesis is a hallmark of glioblastomas, but anti-angiogenic therapies have fallen short of the initial expectations to relevantly change the clinical course of the disease. Only one agent, the anti-vascular endothelial growth factor (VEGF)-A antibody bevacizumab, has shown meaningful efficacy in controlled clinical trials in glioblastoma, so far. In primary and recurrent glioblastoma, this efficacy is, however, limited to prolonging progression-free survival and to generating some additional palliative benefits, without affecting overall survival in the total population of glioblastoma patients. Here, we give an overview of the current status of anti-angiogenic therapy in glioblastoma, including how it is currently used in the clinic. Furthermore, we discuss avenues of biomarker research aiming to identify those glioblastoma patients with a higher likelihood of profiting from anti-VEGF-A therapies (and to identify those who will not). Together with novel anti-angiogenic treatment targets and combination regimens under development today, those might improve the current clinical benefits from this class of drugs in glioblastoma.

摘要

血管生成是胶质母细胞瘤的一个标志,但抗血管生成疗法未能达到最初改变疾病临床过程的预期。迄今为止,只有一种药物,即抗血管内皮生长因子(VEGF-A)抗体贝伐珠单抗,在胶质母细胞瘤的对照临床试验中显示出有意义的疗效。然而,在原发性和复发性胶质母细胞瘤中,这种疗效仅限于延长无进展生存期并产生一些额外的姑息性益处,而不会影响胶质母细胞瘤患者的总体生存率。在这里,我们概述了抗血管生成疗法在胶质母细胞瘤中的现状,包括其在临床上的当前应用。此外,我们还讨论了生物标志物研究的途径,旨在识别那些更有可能从抗 VEGF-A 治疗中获益的胶质母细胞瘤患者(并识别那些不会获益的患者)。与今天正在开发的新型抗血管生成治疗靶点和联合方案一起,这些可能会提高此类药物在胶质母细胞瘤中的当前临床获益。

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