Improved tumor oxygenation and survival in glioblastoma patients who show increased blood perfusion after cediranib and chemoradiation

摘要

The mechanism by which anti-angiogenic therapies inhibit tumor growth remains poorly understood. For instance, impeding tumor vascularization could limit tumor oxygenation and diminish tumor growth potential. A recent paper by Batchelor et al reinforces the idea that this view may be simplistic. Tumor vessels are notoriously abnormal - disorganized, leaky and highly variable in diameter. Anti-angiogenic therapy is thought to prune the vasculature and shore up the blood brain barrier. What effect this has on tumor perfusion, oxygenation and response to therapy remains controversial. Somewhat count-intuitive is the suggestion that pruning and "normalizing" of the tumor vasculature can lead to improved perfusion and oxygenation. While this may be desirable for radiation treatment, reduction of tumoral concentrations of cytotoxic agents, even those that cross an intact blood brain barrier, may also be observed following anti-angiogenic therapy.