Subtype of Glioblastoma Multiforme Responds to Antiangiogenic Chemotherapy
Although the use of antiangiogenic chemotherapy in large, unselected groups of patients with glioblastoma multiforme (GBM) was found ineffective in extending survival, the treatment can provide benefits for patients with a highly vascularized subtype of GBM, a study published in neuro-oncology has shown.1
Previous clinical trials have demonstrated that antiangiogenetic chemotherapy is not effective in glioblastoma multiforme (GBM). Because GBM has a variety of phenotypes and gene-expression patterns, researchers sought to identify a phenotypic subtype of GBM with distinct tumor-image features and molecular activities that may respond to antiangiogenic therapies.
Researchers conducted a retrospective review of preoperative and pretherapy perfusion magnetic resonance (MR) images from 117 patients with GBM in 2 independent cohorts (69 patients who were treated at a local medical center and 48 patients from The Cancer Genome Atlas database) to extract image features of tumor subregions and the whole tumor.
After review of the perfusion MR images, routinely obtained in the diagnosis of GBM, researchers found the samples could be classified into 2 groups: tumors that were highly vascularized (51 patients) and tumors that were not well vascularized (66 patients).
Further investigation into available data on the patients' treatment showed that those patients with highly vascularized tumors who received antiangiogenic chemotherapy survived an average of more than 1 year longer than their counterparts who did not receive antiangiogenic therapy.
These findings demonstrate that although antiangiogenic chemotherapy was not proven effective in large, unselected groups of patients, the treatment can provide benefits for patients with a highly vascularized subtype of GBM. Based upon their findings, the researchers suggest that subtyping GBM can impact how the disease is managed.
1. Liu TT, Achrol AS, Mitchell LA, et al. Magnetic resonance perfusion image features uncover an angiogenic subgroup of glioblastoma patients with poor survival and better response to antiangiogenic treatment. Neuro Oncol. 2016 Dec 22. doi: 10.1093/neuonc/now270. [epub ahead of print]