Malignant gliomas present great difficulties in treatment, with little change over the past 30 years in the median survival time of 15 months. Current treatment options include surgery, radiotherapy (RT), and chemotherapy. New therapies aimed at suppressing the formation of new vasculature (antiangiogenic treatments) or destroying formed tumor vasculature (vascular disrupting agents) show promise. This study summarizes the existing knowledge regarding the processes by which glioblastoma (GBM) tumors acquire resistance to antiangiogenic treatments. The discussion encompasses the activation of redundant proangiogenic pathways, heightened tumor cell invasion and metastasis, resistance induced by hypoxia, creation of vascular mimicry channels, and regulation of the tumor immune microenvironment. Subsequently, we explore potential strategies to overcome this resistance, such as combining antiangiogenic therapies with other treatment methods, personalizing treatments for each patient, focusing on new therapeutic targets, incorporating immunotherapy, and utilizing drug delivery systems based on nanoparticles. Additionally, we would like to discuss the limitations of existing methods and potential future directions to enhance the beneficial effects of antiangiogenic treatments for patients with GBM. Therefore, this review aims to enhance the research outcome for GBM and provide a more promising opportunity by thoroughly exploring the mechanisms of resistance and investigating novel therapeutic strategies.
恶性胶质瘤的治疗面临巨大挑战，过去30年间患者中位生存期始终维持在15个月左右，未见明显改善。目前主要治疗手段包括手术、放射治疗和化学治疗。针对抑制新生血管形成（抗血管生成治疗）或破坏已形成肿瘤血管（血管破坏剂）的新型疗法展现出良好前景。本研究系统总结了胶质母细胞瘤对血管生成治疗产生耐药性的现有认知，重点探讨了冗余促血管生成通路的激活、肿瘤细胞侵袭转移能力增强、低氧诱导的耐药机制、血管拟态通道的形成以及肿瘤免疫微环境调控等关键过程。在此基础上，我们深入探索了克服耐药性的潜在策略，包括抗血管生成疗法与其他治疗方式的联合应用、个体化治疗方案设计、新型治疗靶点开发、免疫治疗整合以及基于纳米颗粒的药物递送系统运用。同时，本文还将讨论现有方法的局限性及未来可能发展方向，以期提升抗血管生成治疗对胶质母细胞瘤患者的临床获益。本综述旨在通过系统解析耐药机制并探索新型治疗策略，为改善胶质母细胞瘤临床疗效提供更具前景的研究方向。
肿瘤(癌症)患者之家