Gregory L. Pishko1, Morad Nasseri1, Seymur Gahramanov1, Leslie L. Muldoon1, Edward A. Neuwelt1, 2
1Oregon Health & Science University, Portland, OR, United States; 2Veterans Affairs Medical Center , Portland, OR, United States
Timing and sequencing of chemotherapy and anti-angiogenic therapy may play an important role in anti-brain tumor efficacy. A pilot study was conducted to use MRI to elucidate vascular and interstitial fluid differences that correspond with the timing of temozolomide (chemotherapy) and bevacizumab (anti-angiogenic) delivery. Rats with intracerebrally implanted human gliomas were randomized to three treatment groups: control, bevacizumab followed by temozolomide 4 days later, and temozolomide followed by bevacizumab 4 days later. Permeability measurements and T2W imaging demonstrated that it may be more effective to deliver chemotherapy before anti-angiogenic therapy and warrants further study.