Antiangiogenic therapy in malignant gliomas

Purpose of review Antiangiogenic drugs are increasingly used in malignant glioma therapy. This article reviews the rationale for targeting angiogenesis in malignant gliomas, summarizes relevant clinical trial results, and discusses promising avenues of investigation in antiangiogenic therapy. Recent findings Combination therapy with bevacizumab, the humanized monoclonal antibody against vascular endothelial growth factor, and irinotecan has emerged as the treatment of choice for recurrent malignant gliomas, prolonging progression-free survival markedly in comparison with historical controls. Several small molecule tyrosine kinase inhibitors of the vascular endothelial growth factor receptor are under investigation and show promise as well. Summary Antiangiogenic treatments are effective and well tolerated options for recurrent malignant glioma, Future studies will determine whether these drugs have a role in first line therapy. Studies are in progress to elucidate mechanisms of resistance and suggest approaches to further improve survival in patients with these challenging tumors.