Treatment of recurrent high-grade gliomas

Abstract

Although therapies for patients with recurrent high-grade gliomas are limited, there has been important progress recently. This review summarizes current treatments for recurrent high-grade gliomas with an emphasis on more novel approaches. There is increasing evidence that antiangiogenic therapies have activity in high-grade gliomas. Recently, the United States Food and Drug Administration granted accelerated approval of bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor, for the treatment of recurrent glioblastomas. Bevacizumab decreases corticosteroid requirements and improves radiologic response rates and progression-free survival. The extent to which these agents prolong overall survival remains to be determined. There is also emerging evidence that other therapies such as dose-dense and metronomic temozolomide regimens, targeted molecular agents, and other antiangiogenic therapies may have activity in recurrent high-grade gliomas. Although there has been progress in treating recurrent high-grade gliomas, the prognosis remains poor and much work still needs to be done to improve on the current results of antiangiogenic and targeted molecular therapies, as well as other novel therapies.