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ASCO Educational Book; 2009
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Antiangiogenic Therapies for Malignant Gliomas

Patrick Y. Wen, MD, Andrew D. Norden, MD, and Jan Drappatz, MD

From the 1. Center for Neuro-Oncology, Department of Medical Oncology, Dana-Farber/Brigham and Women’s Cancer Center; 2. Division of Neuro-Oncology, Department of Neurology, Brigham and Women’s Hospital; 3. Harvard Medical School

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

Address reprint requests to Patrick Y. Wen, Center for Neuro-Oncology, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115; e-mail: pwen{at}partners.org

Overview: Malignant gliomas (MG) are the most common type of malignant primary brain tumor. Each year, approximately 14,000 new cases are diagnosed in the United States.1 Despite optimal treatment, median survival is 12 to 15 months for patients with glioblastomas (GBM) and 2 to 5 years for anaplastic gliomas (AG).1,2 In 2005, a phase III trial indicated that the addition of temozolomide chemotherapy to radiation therapy (RT) for the treatment of newly-diagnosed GBM prolonged median survival from 12.1 to 14.6 months.2 This regimen is now the standard therapy for GBM. For patients with recurrent GBM, 6-month progression-free survival (PFS6) is 21% following temozolomide,3 whereas PFS6 for AG is 46%.4 Median overall survival for patients with recurrent GBM is usually less than 6 months; it is less than 1 year for patients with recurrent AG.5 There is increasing evidence that antiangiogenic therapy has promising activity for patients with MG. This review will summarize the current experience and limitations of targeting angiogenesis in MG and will discuss potential future directions for therapy.