Revival of the VEGF ligand family?

The failure of anti-angiogenic drugs to increase the survival of glioblastoma (GBM) patients was certainly one of the most disappointing results of the last 10 years in neuro-oncology. A meta-analysis of available clinical trials with various compounds and encompassing more than 4300 patients confirmed the lack of survival benefit either as first- or second-line treatment.¹ Despite this, the use of bevacizumab, a monoclonal antibody against vascular endothelial growth factor A (VEGF-A) and the most promising anti-angiogenic agent on the market, remains a matter of debate. Bevacizumab is approved for recurrent GBM in several countries, including the US, Australia, and Japan,² and although not approved by the European Medical Agency, it continues to be used in some European countries as a salvage therapy. There is lingering hope that a subpopulation of patients benefiting from the drug may be identified and/or that a combination treatment may be effective.