Antiangiogenic Therapy for Malignant Brain Tumors: Does It Still Matter? 2023

Alessia Pellerino, and Francesco Bruno, and Riccardo Soffietti, and Roberta Rudà
Division of Neuro‑Oncology, Department of Neuroscience "Rita Levi Montalcini", University and City of Health and Science Hospital, 10126, Turin, Italy.

To summarize the mechanisms of tumor angiogenesis and resistance to antiangiogenic therapy, and the influence on tumor microenvironment. Several clinical trials have investigated the activity of anti-VEGF monoclonal antibodies and tyrosine kinase inhibitors in glioblastoma, shedding the light on their limitations in terms of disease control and survival. We have outlined the mechanisms of resistance to antiangiogenic therapy, including vessel co-option, hypoxic signaling in response to vessel destruction, modulation of glioma stem cells, and trafficking of tumor-associated macrophages in tumor microenvironment. Moreover, novel generation of antiangiogenic compounds for glioblastoma, including small interfering RNAs and nanoparticles, as a delivery vehicle, could enhance selectivity and reduce side effects of treatments. There is still a rationale for the use of antiangiogenic therapy, but a better understanding of vascular co-option, vascular mimicry, and dynamic relationships between immunosuppressive microenvironment and blood vessel destruction is crucial to develop next-generation antiangiogenic compounds.

UI MeSH Term Description Entries
D009389 Neovascularization, Pathologic A pathologic process consisting of the proliferation of blood vessels in abnormal tissues or in abnormal positions. Angiogenesis, Pathologic,Angiogenesis, Pathological,Neovascularization, Pathological,Pathologic Angiogenesis,Pathologic Neovascularization,Pathological Angiogenesis,Pathological Neovascularization
D001932 Brain Neoplasms Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain. Brain Cancer,Brain Metastases,Brain Tumors,Cancer of Brain,Malignant Primary Brain Tumors,Neoplasms, Intracranial,Benign Neoplasms, Brain,Brain Neoplasm, Primary,Brain Neoplasms, Benign,Brain Neoplasms, Malignant,Brain Neoplasms, Malignant, Primary,Brain Neoplasms, Primary Malignant,Brain Tumor, Primary,Brain Tumor, Recurrent,Cancer of the Brain,Intracranial Neoplasms,Malignant Neoplasms, Brain,Malignant Primary Brain Neoplasms,Neoplasms, Brain,Neoplasms, Brain, Benign,Neoplasms, Brain, Malignant,Neoplasms, Brain, Primary,Primary Brain Neoplasms,Primary Malignant Brain Neoplasms,Primary Malignant Brain Tumors,Benign Brain Neoplasm,Benign Brain Neoplasms,Benign Neoplasm, Brain,Brain Benign Neoplasm,Brain Benign Neoplasms,Brain Cancers,Brain Malignant Neoplasm,Brain Malignant Neoplasms,Brain Metastase,Brain Neoplasm,Brain Neoplasm, Benign,Brain Neoplasm, Malignant,Brain Neoplasms, Primary,Brain Tumor,Brain Tumors, Recurrent,Cancer, Brain,Intracranial Neoplasm,Malignant Brain Neoplasm,Malignant Brain Neoplasms,Malignant Neoplasm, Brain,Neoplasm, Brain,Neoplasm, Intracranial,Primary Brain Neoplasm,Primary Brain Tumor,Primary Brain Tumors,Recurrent Brain Tumor,Recurrent Brain Tumors,Tumor, Brain
D005909 Glioblastoma A malignant form of astrocytoma histologically characterized by pleomorphism of cells, nuclear atypia, microhemorrhage, and necrosis. They may arise in any region of the central nervous system, with a predilection for the cerebral hemispheres, basal ganglia, and commissural pathways. Clinical presentation most frequently occurs in the fifth or sixth decade of life with focal neurologic signs or seizures. Astrocytoma, Grade IV,Giant Cell Glioblastoma,Glioblastoma Multiforme,Astrocytomas, Grade IV,Giant Cell Glioblastomas,Glioblastoma, Giant Cell,Glioblastomas,Glioblastomas, Giant Cell,Grade IV Astrocytoma,Grade IV Astrocytomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000068258 Bevacizumab An anti-VEGF humanized murine monoclonal antibody. It inhibits VEGF RECEPTORS and helps to prevent PATHOLOGIC ANGIOGENESIS. Avastin,Bevacizumab-awwb,Mvasi,Bevacizumab awwb
D042461 Vascular Endothelial Growth Factor A The original member of the family of endothelial cell growth factors referred to as VASCULAR ENDOTHELIAL GROWTH FACTORS. Vascular endothelial growth factor-A was originally isolated from tumor cells and referred to as "tumor angiogenesis factor" and "vascular permeability factor". Although expressed at high levels in certain tumor-derived cells it is produced by a wide variety of cell types. In addition to stimulating vascular growth and vascular permeability it may play a role in stimulating VASODILATION via NITRIC OXIDE-dependent pathways. Alternative splicing of the mRNA for vascular endothelial growth factor A results in several isoforms of the protein being produced. Vascular Endothelial Growth Factor,Vascular Endothelial Growth Factor-A,GD-VEGF,Glioma-Derived Vascular Endothelial Cell Growth Factor,VEGF,VEGF-A,Vascular Permeability Factor,Vasculotropin,Glioma Derived Vascular Endothelial Cell Growth Factor,Permeability Factor, Vascular
D059016 Tumor Microenvironment The milieu surrounding neoplasms consisting of cells, vessels, soluble factors, and molecules, that can influence and be influenced by, the neoplasm's growth. Cancer Microenvironment,Cancer Microenvironments,Microenvironment, Cancer,Microenvironment, Tumor,Microenvironments, Cancer,Microenvironments, Tumor,Tumor Microenvironments
D020533 Angiogenesis Inhibitors Agents and endogenous substances that antagonize or inhibit the development of new blood vessels. Angiogenesis Factor Inhibitor,Angiogenesis Inhibitor,Angiogenetic Antagonist,Angiogenetic Inhibitor,Angiogenic Antagonist,Angiogenic Antagonists,Angiogenic Inhibitor,Angiostatic Agent,Angiostatic Agents,Anti-Angiogenetic Agent,Anti-Angiogenic Drug,Anti-Angiogenic Drugs,Antiangiogenic Agent,Neovascularization Inhibitor,Neovascularization Inhibitors,Angiogenesis Factor Inhibitors,Angiogenetic Antagonists,Angiogenetic Inhibitors,Angiogenic Inhibitors,Antagonists, Angiogenic,Anti-Angiogenesis Effect,Anti-Angiogenesis Effects,Anti-Angiogenetic Agents,Antiangiogenesis Effect,Antiangiogenesis Effects,Antiangiogenic Agents,Inhibitors, Angiogenesis,Inhibitors, Angiogenetic,Inhibitors, Angiogenic,Inhibitors, Neovascularization,Agent, Angiostatic,Agent, Anti-Angiogenetic,Agent, Antiangiogenic,Agents, Angiostatic,Agents, Anti-Angiogenetic,Agents, Antiangiogenic,Antagonist, Angiogenetic,Antagonist, Angiogenic,Antagonists, Angiogenetic,Anti Angiogenesis Effect,Anti Angiogenesis Effects,Anti Angiogenetic Agent,Anti Angiogenetic Agents,Anti Angiogenic Drug,Anti Angiogenic Drugs,Drug, Anti-Angiogenic,Drugs, Anti-Angiogenic,Effect, Anti-Angiogenesis,Effect, Antiangiogenesis,Effects, Anti-Angiogenesis,Effects, Antiangiogenesis,Factor Inhibitor, Angiogenesis,Factor Inhibitors, Angiogenesis,Inhibitor, Angiogenesis,Inhibitor, Angiogenesis Factor,Inhibitor, Angiogenetic,Inhibitor, Angiogenic,Inhibitor, Neovascularization,Inhibitors, Angiogenesis Factor

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