Neurological Surgery 脳神経外科43巻8号

2015年08月発行

総説

グリオーマ血管新生，浸潤に対する分子標的薬

著者： 黒住和彦¹ 伊達勲¹

所属機関： ¹岡山大学大学院脳神経外科

ページ範囲：P.691 - P.701

Ⅰ．はじめに
　グリオーマは原発性脳腫瘍の約30%を占めるが，診断と治療の医療技術が進歩しているにもかかわらず，未だ十分な治療成績が得られていない⁴⁰⁾．近年，アルキル化剤であるtemozolomide（TMZ）により，全生存期間の延長効果が認められているが，手術，放射線療法，化学療法を併用しても極めて予後不良の腫瘍である．その理由としては，グリオーマの早期増大，進展，治療抵抗性獲得，腫瘍血管新生や腫瘍浸潤が関与している．
　最近ではさまざまな分子標的薬が開発されている．その代表格である抗血管新生薬のうち，抗vascular endothelial growth factor（VEGF）モノクローナル抗体のbevacizumabは無再発生存期間の延長効果が認められてはいるが^15,16,60)，全生存期間の延長効果は得られておらず，グリオーマに対する効果的な分子標的薬は開発途上であるともいえる．本稿では，グリオーマの血管新生，腫瘍浸潤に関する標的分子，新規分子標的薬と臨床試験について概説する．

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