Angiogenesis inhibitors - a new opportunity in cancer treatment. clinical case – recurrent glioblastoma

Abstract

Introduction: Angiogenesis (from gr. Angeion blood vessel and genesis - birth) is the process of forming new vessels, from the network of existing vessels, the phenomenon begins during fetal life and continues in child and adult ensuring growth and development. Aberrations of phenomenon can be a condition sin quo non in the pathogenesis of diseases such as cancer. Angiogenesis inhibitors are revolutionary products called molecular targeted therapies aimed to inhibiting the progression of essential processes in carcinogenesis, one of which is angiogenesis. Objectives: 1. To evaluate the effectiveness of treatment with bevacizumab in recurrent glioblastoma; 2. To appreciate the tolerability of the product by the patient. Adverse reactions. Clinical case: Current research is a retrospective analysis of a clinical case, the patient A., 28 years old, diagnosed with recurrent glioblastoma and treated in Section of Chemotherapy No.2 of the Oncological Institute of Chisinau, the patient was monitored from May 2010 to November 2011. The evolution of treatment with bevacizumab was monitored using brain MRI executed at optimal intervals.Results: In the absence of blood vessels who will infiltrate tumor tissue, it cannot exceed 2 mm3 in volume, because oxygen and nutrients can diffuse freely through the tissues just over a distance of approx. 200 micrometres, which limits tumor growth and subsequent the metastasis via blood and lymphatic vessels. Preventing the activation of tyrosine kinases (TK), angiogenesis inhibitors limit the proliferation and migration of cells involved in an angiogenesis process (endoteliocyts, fibroblasts, myocytes). The target can be achieved either through monoclonal antibodies wich working as blocking ligand-receptor interaction: bevacizumab; trastuzumab, or small molecules that interact directly with the intracellular TK acting as competitive inhibitors of ATP binding: imatinib, pazopanib. Conclusion: 1. For the presented patient the administration of a suitable conservative treatment, then apply a contemporary regimen of treatment with Avastin, allowed an increase of survival by 19 months, compared with the average statistics for patients with similar staging, but more important is increasing the quality of life and reintegration of the patient in the family and society;2. Inhibitors of tumor angiogenesis is a group of anticancer drugs without haematological toxicity (aplastic anemia, neutropenia are very common result of classic chemotherapy), and without hepatotoxicity, because not involved in DNA replication they not cause other cancers.