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27

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

Targeted therapy

Targeted therapy is a cancer treatment that affects

molecules that are key to cancer cells. It differs from

classic chemotherapy, which affects a wider range of

cells. As such, targeted therapy is less likely to harm

normal cells than chemotherapy.

At this time, only one targeted therapy is advised by

NCCN experts for gliomas. It is briefly described next.

Some side effects are listed. Ask your treatment team

for a full list of common and rare side effects. Parts 3

through 5 address when targeted therapy is an option.

VEGF pathway

Cancer cells need the food and oxygen in blood to

grow. Cancer cells get blood from blood vessels

that have grown into the tumor. VEGF (

v

ascular

e

ndothelial

g

rowth

f

actor) is one of the molecules

that triggers the growth of these blood vessels.

VEGF is made by cancer cells. It travels from cancer

cells to endothelial cells. Endothelial cells form blood

vessels. VEGF attaches to surface receptors on the

outside of endothelial cells. Attachment of VEGF to

surface receptors triggers growth signals.

Bevacizumab

Bevacizumab attaches to VEGF before it attaches

to receptors on endothelial cells.

See Figure 6

. As

a result, VEGF can’t attach to receptors. No growth

signals caused by VEGF are started.

Bevacizumab is given by infusion. It takes about

90 minutes to get the first dose and 30 minutes

for later doses. It may be received alone or with

chemotherapy to treat some types of gliomas.

Common side effects of bevacizumab are high

blood pressure, diarrhea, and feeling tired and

weak. You might also have nosebleeds, shortness of

breath, and abnormal levels of protein in your urine

(proteinuria). Rare but serious side effects include

stroke, blood clots, heart attack, kidney damage,

holes in the intestine, and bleeding in your body

including your head.

2

Test and treatment overview

Targeted therapy

Figure 6

VEGF targeted therapy

Cancer cells need blood to grow.

They send VEGF to endothelial

cells to start the growth of

blood vessels. Bevacizumab

disables VEGF from attaching to

receptors. As a result, VEGF can’t

start cell growth.

Copyright © 2016 National Comprehensive Cancer Network® (NCCN®).

www.nccn.org

endothelial cell

bevacizumab

VEGF