Liu Xinliang, Chen Zhigang, Yan Pengwei, Yang Tao, Zong Dan, Guo Wenjie, He Xia
Department of Radiotherapy, Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, The Third Affiliated Hospital of Nanjing Medical University, Changzhou Medical Center, Nanjing Medical University Changzhou 213000, Jiangsu, China.
Department of Radiotherapy, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, and Jiangsu Institute of Cancer Research Nanjing 210009, Jiangsu, China.
Am J Cancer Res. 2025 Apr 25;15(4):1874-1901. doi: 10.62347/RNUE7193. eCollection 2025.
Hypervascularization is a notable pathological hallmark of glioblastoma (GBM). Bevacizumab (Bev) remains the sole antiangiogenic agent approved by the U.S. Food and Drug Administration (FDA) for GBM treatment. The approval for this indication was supported by several phase II studies demonstrating that Bev significantly improved progression-free survival and the best imaging response in patients with recurrent GBM. Three large phase III randomized controlled trials reported that Bev did not significantly extend overall survival (OS). Nevertheless, Bev has been shown to delay the deterioration of patients' quality of life by postponing tumor progression. This review synthesizes findings from recent investigations exploring Bev in combination with targeted therapies, immunotherapy, or reirradiation. Additionally, this review discusses dosing regimens, administration, treatment failure patterns, third-line therapeutic applications, and prognostic markers of Bev. By synthesizing current evidence, this review aims to inform clinical decision-making for neuro-oncology clinicians.
血管过度增生是胶质母细胞瘤(GBM)显著的病理特征。贝伐单抗(Bev)仍然是美国食品药品监督管理局(FDA)批准用于治疗GBM的唯一抗血管生成药物。多项II期研究支持了这一适应症的批准,这些研究表明,Bev显著改善了复发性GBM患者的无进展生存期和最佳影像学反应。三项大型III期随机对照试验报告称,Bev并未显著延长总生存期(OS)。然而,已证明Bev可通过延缓肿瘤进展来延迟患者生活质量的恶化。本综述综合了近期探索Bev与靶向治疗、免疫治疗或再程放疗联合应用的研究结果。此外,本综述还讨论了Bev的给药方案、给药方式、治疗失败模式、三线治疗应用及预后标志物。通过综合当前证据,本综述旨在为神经肿瘤临床医生的临床决策提供参考。