Antiangiogenic therapy for high-grade gliomas: current concepts and limitations

Area of Science:

• Neuro-oncology
• Cancer biology
• Tumor microenvironment

Background:

• Glioblastoma (GBM) exhibits significant tumor angiogenesis, suggesting antiangiogenic therapies as a potential treatment strategy.
• Current antiangiogenic strategies target the VEGF pathway, VEGF-independent pathways, and endothelial cell migration.

Purpose of the Study:

• To review the role and limitations of antiangiogenic therapy in glioblastoma treatment.
• To identify areas for future research in targeting GBM angiogenesis.

Main Methods:

• Literature review of antiangiogenic therapies for glioblastoma.
• Analysis of current therapeutic targets and their efficacy.
• Evaluation of preclinical models and resistance mechanisms.

Main Results:

• Antiangiogenic therapy can induce rapid radiological responses and reduce brain edema in GBM patients.
• Significant improvements in overall survival have not been consistently demonstrated.
• Challenges include inadequate animal models, inherent or acquired therapy resistance, and limited understanding of peritumor angiogenesis.

Conclusions:

• While antiangiogenic therapy offers symptomatic benefits for GBM, its impact on survival remains limited.
• Future research must address limitations in preclinical models, investigate resistance mechanisms, and explore novel angiogenic targets.
• The ideal therapeutic target for glioblastoma angiogenesis is yet to be identified.