New treatment options in the management of glioblastoma multiforme: a focus on bevacizumab

Abstract

Glioblastoma multiforme (GBM) is the most common malignant primary brain tumor in adults and carries the poorest prognosis. Despite recent progress in molecular biology, neuro-imaging and neuro-surgical care, the management of patients with GBM continues to harbor significant challenges. Survival after diagnosis is poor even with the most aggressive approach using multimodality therapy. Although the etiology of malignant gliomas is not known, the dependency of tumor growth on angiogenesis has identified this pathway as a promising therapeutic target. Bevacizumab was the first antiangiogenic therapy approved for use in cancer and received accelerated Food and Drug Administration approval for the treatment of recurrent GBM in 2009, the first new drug for this disease in over a decade. This review describes the rationale behind the treatment of GBM with bevacizumab. The pharmacology, efficacy, safety and tolerability of bevacizumab will also be reviewed.

Keywords: angiogenesis; bevacizumab; glioblastoma multiforme.

Figure 1

A) Axial T1-weighted, post-contrast image of the brain in a patient with glioblastoma multiforme who progressed on temozolomide therapy. B) Response after 2 months of bevacizumab monotherapy.