Update on bevacizumab and other angiogenesis inhibitors for brain cancer. (June 2013)

• Record Type: Journal Article
• Authors: Rinne, Mikael L; Lee, Eudocia Q; Nayak, Lakshmi; Norden, Andrew D; Beroukhim, Rameen; Wen, Patrick Y; Reardon, David A
• Is Part Of: Expert opinion on emerging drugs. Volume 18:Number 2(2013:Jun.)
• Page Start: 137
• Page End: 153
• Publication Date: 2013-06
• Subjects: angiogenesis -- brain metastases -- glioblastoma -- malignant glioma -- vascular endothelial growth factor; Drugs -- Research -- Handbooks, manuals, etc; Drugs -- Design -- Periodicals; 615.1072
• DOI: 10.1517/14728214.2013.794784
• Languages: English
• ISSNs: 1472-8214

Abstract

Abstract : Introduction: Primary and metastatic brain tumors remain a major challenge. The most common primary adult malignant brain tumor, glioblastoma (GBM), confers a dismal prognosis as does the development of CNS metastases for most systemic malignancies. Anti-angiogenic therapy has been a major clinical research focus in neuro-oncology over the past 5 years. Areas covered: Culmination of this work includes US FDA accelerated approval of bevacizumab for recurrent GBM and the completion of two placebo-controlled Phase III studies of bevacizumab for newly diagnosed GBM. A multitude of anti-angiogenics are in evaluation for neuro-oncology patients but none has thus far surpassed the therapeutic benefit of bevacizumab. Expert opinion: These agents demonstrate adequate safety and the majority of GBM patients derive benefit. Furthermore, their anti-permeability effect can substantially decrease tumor-associated edema leading to stable or improved neurologic function and quality of life. In particular, anti-angiogenics significantly prolong progression-free survival – a noteworthy achievement in the context of infiltrative and destructive brain tumors like GBM; however, in a manner analogous to other cancers, their impact on overall survival for GBM patients is modest at best. Despite substantial clinical research efforts, many fundamental questions regarding anti-angiogenic agents in brain tumor patients remain unanswered.