Journal
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
Volume 39, Issue 8, Pages 1460-1468Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0271678X19859847
Keywords
Glioblastoma; blood-brain barrier; cerebral edema; dexamethasone; anti-vascular endothelial growth factor; Angiopoietin; Tie2; vascular endothelial protein tyrosine phosphatase
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Funding
- Else-Kroner Foundation Research College fellowship
- Clinical Translation Platform of the Frankfurt Cancer Institute
- German Consortium for Translational Cancer Research (DKTK), partner site Frankfurt/Mainz, Germany
- LOEWE Center for Personalized Translational Epilepsy Research (CePTER)
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Glioblastoma is a highly aggressive and treatment resistant primary brain tumor. Features of glioblastoma include peritumoral cerebral edema, the major contributor to neurological impairment. Although the current clinical approach to edema management is administration of the synthetic corticoid dexamethasone, increasing evidence indicates numerous adverse effects of dexamethasone on glioblastoma burden at the molecular, cellular and clinical level. The contradictions of dexamethasone for glioblastoma and brain metastasis therapy are discussed in this article. Finally, alternative strategies for cerebrovascular edema therapy with vascular stabilizing, anti-permeability agents that are either approved or in clinical trials for diabetic retinopathy and macula edema, are addressed.
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