Bevacizumab for the treatment of recurrent glioblastoma.
Bevacizumab for the treatment of recurrent glioblastoma.
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DOI：
10.4137/cmo.s7232
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Chamberlain MC
中科院分区：
文献类型：
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作者：
Chamberlain MC
尽管前期治疗取得了进展，但绝大多数胶质母细胞瘤（GBM）患者的预后很差，几乎所有患者都会复发并导致疾病相关死亡。胶质母细胞瘤是一种高度血管化的癌症，其血管内皮生长因子（VEGF）的表达水平升高，VEGF是血管生成的主要介质。令人信服的生物学原理，改进治疗的需要，以及贝伐单抗在其他癌症中研究的积极结果，导致贝伐单抗治疗复发性GBM的评估。贝伐单抗是一种靶向VEGF的人源化单克隆抗体，已被证明可以改善复发性GBM患者联合化疗（最常见的是伊立替康）的预后，基于两项前瞻性2期研究的阳性结果，贝伐单抗被美国食品和药物管理局（FDA）加速批准为复发性GBM的单药。贝伐单抗治疗具有可控的、类别特异性的毒性，因为仅在少数患者中观察到严重的治疗相关不良事件。为了解决关于贝伐珠单抗最佳使用的问题和争议，本综述的目的是总结贝伐珠单抗在复发性GBM患者中的临床疗效和安全性数据，围绕贝伐珠单抗给药的实际问题，以及贝伐珠单抗在治疗GBM中的持续研究。
Despite advances in upfront therapy, the prognosis in the great majority of patients with glioblastoma (GBM) is poor as almost all recur and result in disease-related death. Glioblastoma are highly vascularized cancers with elevated expression levels of vascular endothelial growth factor (VEGF), the dominant mediator of angiogenesis. A compelling biologic rationale, a need for improved therapy, and positive results from studies of bevacizumab in other cancers led to the evaluation of bevacizumab in the treatment of recurrent GBM. Bevacizumab, a humanized monoclonal antibody that targets VEGF, has been shown to improve patient outcomes in combination with chemotherapy (most commonly irinotecan) in recurrent GBM, and on the basis of positive results in two prospective phase 2 studies, bevacizumab was granted accelerated approval by the US Food and Drug Administration (FDA) as a single agent in recurrent GBM. Bevacizumab therapy is associated with manageable, class-specific toxicity as severe treatment-related adverse events are observed in only a minority of patients. With the goal of addressing questions and controversies regarding the optimal use of bevacizumab, the objective of this review is to provide a summary of the clinical efficacy and safety data of bevacizumab in patients with recurrent GBM, the practical issues surrounding the administration of bevacizumab, and ongoing investigations of bevacizumab in managing GBM.