• N García-Romero, I Palacín-Aliana, R Madurga, J Carrión-Navarro, S Esteban-Rubio, B Jiménez, A Collazo, F Pérez-Rodríguez, A Ortiz de Mendivil, C Fernández-Carballal, S García-Duque, J Diamantopoulos-Fernández, C Belda-Iniesta, R Prat-Acín, P Sánchez-Gómez, E Calvo, and A Ayuso-Sacido.
• Fundación de Investigación HM Hospitales, HM Hospitales, Madrid, Spain.
• Bmc Med. 2020 Jun 22; 18 (1): 142.

BackgroundGlioblastoma (GBM) is one of the most aggressive and vascularized brain tumors in adults, with a median survival of 20.9 months. In newly diagnosed and recurrent GBM, bevacizumab demonstrated an increase in progression-free survival, but not in overall survival.MethodsWe conducted an in silico analysis of VEGF expression, in a cohort of 1082 glioma patients. Then, to determine whether appropriate bevacizumab dose adjustment could increase the anti-angiogenic response, we used in vitro and in vivo GBM models. Additionally, we analyzed VEGFA expression in tissue, serum, and plasma in a cohort of GBM patients before and during bevacizumab treatment.ResultsWe identified that 20% of primary GBM did not express VEGFA suggesting that these patients would probably not respond to bevacizumab therapy as we proved in vitro and in vivo. We found that a specific dose of bevacizumab calculated based on VEGFA expression levels increases the response to treatment in cell culture and serum samples from mice bearing GBM tumors. Additionally, in a cohort of GBM patients, we observed a correlation of VEGFA levels in serum, but not in plasma, with bevacizumab treatment performance.ConclusionsOur data suggest that bevacizumab dose adjustment could improve clinical outcomes in Glioblastoma treatment.

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