[[Adult brainstem glioma]]s are characterized into subtypes depending on clinicopathologic and radiographic characteristics. Among them, [[brainstem glioblastoma]] is the most malignant and has the poorest [[prognosis]], with surgical [[resection]] for this condition posing a great challenge and risk. Postoperative synchronous radiotherapy and [[temozolomide]] (TMZ) [[chemotherapy]], or "Stupp protocol", is the standard of care for [[glioblastoma]]s. However, [[antiangiogenic]] [[therapy]], which is widely used for different [[cancer]]s, is now an alternative treatment for [[malignant tumor]]s. [[Angiogenesis]] is one of the pathological features of [[glioblastoma]] and is involved in [[tumor progression]] and [[metastases]]. Besides, previous studies suggested a better response to antiangiogenic therapy in some solid tumors with [[TP53]] mutation than TP53 wide-type. [[Apatinib]] is a novel, oral, small-molecule tyrosine kinase inhibitor that mainly targets vascular endothelial growth factor receptor-2 (VEGFR-2) to inhibit angiogenesis. In addition, [[apatinib]] can cross the blood-brain barrier and improve encephaledema. A report by Zhu et al. describes the use of concurrent [[apatinib]] and dose-dense TMZ in a clinically inoperable patient who had a refractory brainstem glioblastoma with a TP53 [[germline]] [[mutation]]. He obtained an ongoing [[progression-free survival]] (PFS) of nearly 16.0 months after resistance to TMZ maintenance. Due to the patient's circumstances, apatinib and TMZ was considered an effective and safe treatment method
((Zhu Y, Zhao L, Xu Y, Zhan W, Sun X, Xu X. Combining [[apatinib]] and [[temozolomide]]
for [[brainstem glioblastoma]]: a [[case report]] and [[review]] of [[literature]]. Ann Palliat
Med. 2022 Jan;11(1):394-400. doi: 10.21037/apm-22-22. PMID: 35144430.))