The impact of bevacizumab treatment on survival and quality of life in newly diagnosed glioblastoma patients

Abstract

Glioblastoma multiforme (GBM) remains one of the most devastating tumors, and patients have a median survival of 15 months despite aggressive local and systemic therapy, including maximal surgical resection, radiation therapy, and concomitant and adjuvant temozolomide. The purpose of antineoplastic treatment is therefore to prolong life, with a maintenance or improvement of quality of life. GBM is a highly vascular tumor and overexpresses the vascular endothelial growth factor A, which promotes angiogenesis. Preclinical data have suggested that anti-angiogenic treatment efficiently inhibits tumor growth. Bevacizumab is a humanized monoclonal antibody against vascular endothelial growth factor A, and treatment has shown impressive response rates in recurrent GBM. In addition, it has been shown that response is correlated to prolonged survival and improved quality of life. Several investigations in newly diagnosed GBM patients have been performed during recent years to test the hypothesis that newly diagnosed GBM patients should be treated with standard multimodality treatment, in combination with bevacizumab, in order to prolong life and maintain or improve quality of life. The results of these studies along with relevant preclinical data will be described, and pitfalls in clinical and paraclinical endpoints will be discussed.

High expression of miR-9 in CD133+glioblastoma cells in chemoresistance to temozolomide

“…Glioblastoma Multiforme (GBM) is the most common adult intracranial malignancy, and the most aggressive cancer with rv11-month median survival [1]. The current treatments include surgical resection, radiation and chemotherapy with the frontline temozolomide (TMZ).…”

Radiologic Features and Expression of Vascular Endothelial Growth Factor Stratify Survival Outcomes in Patients with Glioblastoma

“…18,19 Glioblastoma is thought to exhibit abnormally high levels of VEGF. 20,21 In this study, we found that VEGF expression alone was not a prognostic factor for patients with glioblastoma. However, VEGF might interact with other potential factors to determine survival outcomes.…”

Hallmarks of glioblastoma: a systematic review

“…Some of the recruited vascular progenitor cells can transform into pericytes or endothelial cells, protecting and stabilising the newly formed vessel 35. Bevacizumab (BEV) is a humanised monoclonal antibody that targets the vascular endothelial growth factor receptor 36. It can only cross the blood–brain barrier (BBB) where this is destroyed, as seen in GBM.…”