MRI in patients with high-grade gliomas treated with bevacizumab and chemotherapy

Bevacizumab is a monoclonal antibody that neutralizes vascular endothelial growth factor (VEGF), the key mediator of tumor angiogenesis. VEGF impacts endothelial cell permeability, activation, survival, proliferation, invasion and migration, all of which play a role in tumor progression. In combination with chemotherapy, bevacizumab may improve survival in patients with metastatic colorectal cancer, breast cancer, and lung cancer. (1) Malignant gliomas express VEGF receptors, (2) and glioblastoma cell lines have been shown to secrete VEGF. (3) Therefore, we assessed the early imaging effects of bevacizumab coupled with etoposide, carboplatin, or cpt-11 on recurrent malignant (Grade III and Grade IV) gliomas using contrast-enhanced MRI.