Rahman Md Ataur, Ali Meser M
Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI 48201, USA.
Cancers (Basel). 2024 Aug 27;16(17):2975. doi: 10.3390/cancers16172975.
Malignant gliomas present great difficulties in treatment, with little change over the past 30 years in the median survival time of 15 months. Current treatment options include surgery, radiotherapy (RT), and chemotherapy. New therapies aimed at suppressing the formation of new vasculature (antiangiogenic treatments) or destroying formed tumor vasculature (vascular disrupting agents) show promise. This study summarizes the existing knowledge regarding the processes by which glioblastoma (GBM) tumors acquire resistance to antiangiogenic treatments. The discussion encompasses the activation of redundant proangiogenic pathways, heightened tumor cell invasion and metastasis, resistance induced by hypoxia, creation of vascular mimicry channels, and regulation of the tumor immune microenvironment. Subsequently, we explore potential strategies to overcome this resistance, such as combining antiangiogenic therapies with other treatment methods, personalizing treatments for each patient, focusing on new therapeutic targets, incorporating immunotherapy, and utilizing drug delivery systems based on nanoparticles. Additionally, we would like to discuss the limitations of existing methods and potential future directions to enhance the beneficial effects of antiangiogenic treatments for patients with GBM. Therefore, this review aims to enhance the research outcome for GBM and provide a more promising opportunity by thoroughly exploring the mechanisms of resistance and investigating novel therapeutic strategies.
恶性胶质瘤在治疗上存在巨大困难，过去30年中其15个月的中位生存时间几乎没有变化。目前的治疗选择包括手术、放疗（RT）和化疗。旨在抑制新血管形成（抗血管生成治疗）或破坏已形成的肿瘤血管（血管破坏剂）的新疗法显示出前景。本研究总结了关于胶质母细胞瘤（GBM）肿瘤对抗血管生成治疗产生耐药性的过程的现有知识。讨论内容包括冗余促血管生成途径的激活、肿瘤细胞侵袭和转移的增强、缺氧诱导的耐药性、血管拟态通道的形成以及肿瘤免疫微环境的调节。随后，我们探索克服这种耐药性的潜在策略，例如将抗血管生成疗法与其他治疗方法相结合、为每位患者制定个性化治疗方案、关注新的治疗靶点、纳入免疫疗法以及利用基于纳米颗粒的药物递送系统。此外，我们还想讨论现有方法的局限性以及未来潜在的方向，以增强抗血管生成治疗对GBM患者的有益效果。因此，本综述旨在通过深入探究耐药机制和研究新的治疗策略来提高GBM的研究成果，并提供更有前景的机会。
