Angiogenesis and anti-angiogenic strategies for glioblastomas

The poor prognosis of patients with glioblastoma multiforme in spite of aggressive conventional anticancer therapies has led to the search for new therapeutic strategies. As glioblastomas are highly vascularized and their growth is angiogenesis-dependent, the inhibition of the sprouting of new capillaries from preexisting blood vessels is one of the most promising therapeutic approaches. Different anti-angiogenic strategies have been developed: inhibition of pro-angiogenic factors and/or receptors and/or downstream cell signaling, inactivation of endothelial cells, inhibition of cellular adhesion molecules and/or extracellular matrix remodeling. Inhibitors of angiogenesis are separated into endogenous inhibitors such as angiostatin, trombospondin or alpha interferon and natural or synthetic inhibitors such as thalidomide, antibodies against angiogenic growth factors or inhibitors of tyrosine kinase receptors. In this review, the majority of experimental studies in glioblastoma models in vivo are summarized and clinical perspectives are discussed.