Antiangiogenesis - therapeutic strategies and clinical implications for brain tumors

The poor prognosis of patients with malignant brain tumors in spite of aggr essive multimodality therapy has led to the search for novel therapeutic st rategies. Among the targets for such treatment approaches, tumor angiogenes is has captured the attention of not only the medical field but also of the lay public because of its conceptual departure from traditional methods of cancer therapy. Angiogenesis and vascular proliferation are particularly i mportant in the growth and progression of malignant gliomas and are used as indicators of the degree of malignancy. Recent studies have helped us gain a better understanding of the molecular mediators of this process. It is n ow evident that after the initial formation of malignancy the continued gro wth of a glioma is critically dependent on its angiogenic potential. Hence, several approaches to control angiogenesis are being developed and tested. In the present review, we examine some of these approaches from a therapeu tic perspective and summarize the findings from early human trials of such agents.