Recurrence pattern in glioblastoma multiforme patients treated with anti-angiogenic chemotherapy

Glioblastoma multiforme is the prototype of an angiogenic tumour. Under experimental conditions, anti-angiogenic therapy strategies lead to an increased invasion. Here we report on the pattern of tumour recurrence in glioblastoma patients treated with an anti-angiogenic chemotherapy. A total of 32 patients with glioblastoma multiforme and a residual tumour mass after operation were treated with a continuous low-dose chemotherapy with temozolomide and a COX-II inhibitor, a presumably anti-angiogenic therapy. While anti-tumour activity of this therapy regimen was excellent with a mean overall time to progression of 10.4 (+/- 0.9) months and a mean overall survival of 17.8 (+/- 1.5) months, an unusually high rate of distant recurrences was observed (62.5%). Patients treated with an anti-angiogenic chemotherapy experience distant recurrences at a higher rate than reported for conventional therapies. This may reflect an anti-angiogenic therapy-induced activation of glioma invasion confirming similar recently published experimental results.