Kertmen Neyran, Kavgaci Gozde, Koc Ilgin, Sagol Safak Parlak, Isikay Ahmet Ilkay, Yazici Gozde
Department of Medical Oncology, Hacettepe University Faculty of Medicine, Ankara, Ankara 06230, Turkey.
Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Ankara 06230, Turkey.
Oncol Lett. 2025 Jan 17;29(3):146. doi: 10.3892/ol.2025.14892. eCollection 2025 Mar.
Glioblastoma multiforme (GBM) is a tumor with a high refractory rate to immunotherapy and a low tumor mutational burden phenotype, leading to limited immunogenic neoantigens. The present study aimed to investigate the sequential use of immunotherapy and bevacizumab in patients with GBM, exploring the clinical outcomes and potential complications. Patients received various combinations of immunotherapy and bevacizumab after standard treatment, including surgery, radiotherapy and temozolomide. Clinical courses, radiological findings and treatment outcomes were monitored and documented during each clinical visit through routine physical examinations, imaging studies and review of medical records. The efficacy and side effects of this sequential drug approach remained unclear. The common features of these patients were a marked decline in cognitive function and clinical deterioration, assessed clinically in the absence of obvious tumor progression. Radiological evaluation was also performed, particularly for possible cerebrovascular events. In these cases, the potential for sequential treatment to suppress tumors while inducing cerebrovascular events was also investigated, and patients were not lost to overt tumor progression. Notably, further research is required to clarify the mechanisms of action and complications associated with the sequential use of immunotherapy and bevacizumab in the treatment of GBM.
多形性胶质母细胞瘤（GBM）是一种对免疫疗法难治率高且肿瘤突变负荷表型低的肿瘤，导致免疫原性新抗原有限。本研究旨在探讨免疫疗法和贝伐单抗在GBM患者中的序贯使用，探索临床结果和潜在并发症。患者在接受包括手术、放疗和替莫唑胺在内的标准治疗后接受了免疫疗法和贝伐单抗的各种联合治疗。在每次临床就诊时，通过常规体格检查、影像学检查和病历审查对临床病程、影像学表现和治疗结果进行监测和记录。这种序贯用药方法的疗效和副作用仍不明确。这些患者的共同特征是认知功能明显下降和临床恶化，在无明显肿瘤进展的情况下进行临床评估。还进行了影像学评估，特别是针对可能的脑血管事件。在这些病例中，还研究了序贯治疗在抑制肿瘤的同时诱发脑血管事件的可能性，且患者未因明显的肿瘤进展而失访。值得注意的是，需要进一步研究以阐明免疫疗法和贝伐单抗序贯用于治疗GBM的作用机制和并发症。
