BACKGROUND: Angiogenesis is common in cancer and reflects the requirement for a vascular network to support continued uncontrolled growth. Two strategies of antiangiogenic therapy have emerged; one targeting VEGF (growth-factor-ligand-based antagonists) and the second targeting VEGF receptor (receptor-based antagonists, small-molecule tyrosine kinase inhibitors). METHODS: The literature as reviewed by Reardon et al. [1] regarding treatment of recurrent high-grade gliomas (HGG) with antiangiogenic therapy (predominantly ligand-based and administered in conjunction with cytotoxic chemotherapy) reports response rates of 30 - 60% and 6-month progression-free survival of 25 - 50%. Problems include new antiangiogenic-class side effects and control of administration and timing in relation to surgery. RESULTS/ CONCLUSIONS: Ligand-based antiangiogenic therapy is a compelling targeted therapy for HGG and will continue to emerge as an important antiglioma therapy. Further studies are required to define the population of patients in whom this therapy is of benefit, identify the optimal dose and schedule, characterize the value of co-administered (cytotoxic and targeted) therapies and establish validated response measures.
BACKGROUND: Angiogenesis is common in cancer and reflects the requirement for a vascular network to support continued uncontrolled growth. Two strategies of antiangiogenic therapy have emerged; one targeting VEGF (growth-factor-ligand-based antagonists) and the second targeting VEGF receptor (receptor-based antagonists, small-molecule tyrosine kinase inhibitors). METHODS: The literature as reviewed by Reardon et al. [1] regarding treatment of recurrent high-grade gliomas (HGG) with antiangiogenic therapy (predominantly ligand-based and administered in conjunction with cytotoxic chemotherapy) reports response rates of 30 - 60% and 6-month progression-free survival of 25 - 50%. Problems include new antiangiogenic-class side effects and control of administration and timing in relation to surgery. RESULTS/ CONCLUSIONS: Ligand-based antiangiogenic therapy is a compelling targeted therapy for HGG and will continue to emerge as an important antiglioma therapy. Further studies are required to define the population of patients in whom this therapy is of benefit, identify the optimal dose and schedule, characterize the value of co-administered (cytotoxic and targeted) therapies and establish validated response measures.