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The impact of bevacizumab treatment on survival and quality of life in newly diagnosed glioblastoma patients

Authors Poulsen HS, Urup T, Michaelsen S, Staberg M, Villingshøj M, Lassen U

Received 24 June 2014

Accepted for publication 12 August 2014

Published 26 September 2014 Volume 2014:6 Pages 373—387

DOI https://doi.org/10.2147/CMAR.S39306

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 6

Editor who approved publication: Dr Kenan Onel


Hans Skovgaard Poulsen,1,2,* Thomas Urup,1,2,* Signe Regner Michaelsen,1,2 Mikkel Staberg,1,2 Mette Villingshøj,1,2 Ulrik Lassen1–3

1Department of Radiation Biology, 2Department of Oncology, 3Phase I Unit, The Finsencenter, Copenhagen University Hospital, Copenhagen, Denmark
 
*These authors contributed equally to this work

Abstract: Glioblastoma multiforme (GBM) remains one of the most devastating tumors, and patients have a median survival of 15 months despite aggressive local and systemic therapy, including maximal surgical resection, radiation therapy, and concomitant and adjuvant temozolomide. The purpose of antineoplastic treatment is therefore to prolong life, with a maintenance or improvement of quality of life. GBM is a highly vascular tumor and overexpresses the vascular endothelial growth factor A, which promotes angiogenesis. Preclinical data have suggested that anti-angiogenic treatment efficiently inhibits tumor growth. Bevacizumab is a humanized monoclonal antibody against vascular endothelial growth factor A, and treatment has shown impressive response rates in recurrent GBM. In addition, it has been shown that response is correlated to prolonged survival and improved quality of life. Several investigations in newly diagnosed GBM patients have been performed during recent years to test the hypothesis that newly diagnosed GBM patients should be treated with standard multimodality treatment, in combination with bevacizumab, in order to prolong life and maintain or improve quality of life. The results of these studies along with relevant preclinical data will be described, and pitfalls in clinical and paraclinical endpoints will be discussed.

Keywords: primary treatment, VEGF, quality of life, monoclonal antibody, patient survival, vascular tumor

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