Bevacizumab: A treatment option for recurrent glioblastoma multiforme
Bevacizumab: A treatment option for recurrent glioblastoma multiforme
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DOI：
10.1345/aph.1l030
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发表时间：
2008-10-01
影响因子：
2.9
通讯作者：
Valgus, John M.
中科院分区：
文献类型：
--
作者：
Buie, Larry W.;Valgus, John M.
目的：回顾评价贝伐单抗联合伊立替康治疗复发性多形性胶质母细胞瘤（GBM）对无进展生存期影响的现有文献。MEDLINE数据库（1966- 2008年6月）、科克伦图书馆和国际药物文摘（1970年至2008年6月）进行了使用贝伐单抗，伊立替康，多形性胶质母细胞瘤术语。对从数据源中识别出的所有文章进行了评价。评价贝伐单抗治疗复发性GBM的有效性和安全性的所有临床试验均包括在review.DATA综合：缺氧，诱变，和各种生长因子的分泌都可以导致血管内皮生长因子（VEGF），促血管生成的生长因子，和GBM的血管生成。肿瘤进展依赖于血管生成，抗VEGF治疗已在多种疾病状态中取得成功。然而，目前没有可用的抗VEGF疗法被批准用于治疗GBM。贝伐珠单抗是一种人源化单克隆抗体，可结合并抑制VEGF的活性。与使用单一化疗药物治疗复发性GBM的临床试验数据相比，在细胞毒性化疗（例如伊立替康）中添加贝伐珠单抗似乎可以改善无进展生存率在标准护理下进展的患者，6个月无进展生存率为46%。贝伐单抗是耐受性良好的大多数患者，与适度的风险（11%的2期试验）的静脉thromboembolis.CONCLUSIONS：虽然贝伐单抗和伊立替康的组合是产生积极的结果，复发性GBM患者，更大的，随机临床试验需要进行，以确定贝伐单抗的好处的大小。贝伐珠单抗以10 mg/kg的剂量每两周给药一次，联合伊立替康可改善无进展生存期。
OBJECTIVE: To review the available literature evaluating the effect of bevacizumab on progression-free survival when used in combination with irinotecan for recurrent glioblastoma multiforme (GBM).DATA SOURCES: Searches of MEDLINE (1966-June 2008), the Cochrane Library, and International Pharmaceutical Abstracts (1970-June 2008) were conducted using the terms bevacizumab, irinotecan, and glioblastoma multiforme.STUDY SELECTION AND DATA EXTRACTION: The search was limited to studies conducted in humans. All articles identified from the data sources were evaluated. All clinical trials evaluating the efficacy and safety of bevacizumab in the treatment of recurrent GBM were included in the review.DATA SYNTHESIS: Hypoxia, mutagenesis, and the secretion of various growth factors can all lead to production of vascular endothelial growth factor (VEGF), a proangiogenic growth factor, and angiogenesis in GBM. Neoplastic progression is dependent on angiogenesis, and anti-VEGF therapy has been successful in multiple disease states. However, there are currently no available anti-VEGF therapies approved for treatment of GBM. Bevacizumab is a humanized monoclonal antibody that binds to and inhibits the activity of VEGF When compared with data from clinical trials that use single chemotherapeutic agents in recurrent GBM, the addition of bevacizumab to cytotoxic chemotherapy, such as irinotecan, appears to improve progression-free survival in patents progressing on the standard of care, with a 6-month progression-free survival rate of 46%. Bevacizumab is well tolerated by most patients, with modest risk (11% in Phase 2 trials) of venous thromboembolism.CONCLUSIONS: Although the combination of bevacizumab and irinotecan is producing positive results in patients with recurrent GBM, larger, randomized clinical trials need to be performed to determine the magnitude of the benefit from bevacizumab. Bevacizumab administered biweekly at a dose of 10 mg/kg in combination with irinotecan may improve progression-free survival.