SCRIBNER, Elizabeth; SAUT, Olivier; PAULA, Province; ASIM, Bag; COLIN, Thierry; FATHALLAH, Hassan

doi:10.1371/journal.pone.0115018

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SCRIBNER, Elizabeth
Department of Mathematics [Birmingham, Alabama]

SAUT, Olivier
Modélisation, contrôle et calcul [MC2]

PAULA, Province
Department of neurology [Birmingham, Alabama]

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PLoS ONE. 2014-12-15p. 21

Public Library of Science

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Glioblastoma multiforme (GBM) causes significant neurological morbidity and short survival times. Brain invasion by GBM is associated with poor prognosis. Recent clinical trials of bevacizumab in newly-diagnosed GBM found no beneficial effects on overall survival times; however, the baseline health-related quality of life and performance status were maintained longer in the bevacizumab group and the glucocorticoid requirement was lower. Here, we construct a clinical-scale model of GBM whose predictions uncover a new pattern of recurrence in 11/70 bevacizumab-treated patients. The findings support an exception to the Folkman hypothesis: GBM grows in the absence of angiogenesis by a cycle of proliferation and brain invasion that expands necrosis. Furthermore, necrosis is positively correlated with brain invasion in 26 newly-diagnosed GBM. The unintuitive results explain the unusual clinical effects of bevacizumab and suggest new hypotheses on the dynamic clinical effects of migration by active transport, a mechanism of hypoxia-driven brain invasion.< Réduire

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Effects of Anti-Angiogenesis on Glioblastoma Growth and Migration: Model to Clinical Predictions

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