VEGFA and vascular neoplasm: EPNs are highly vascular tumors; the vascular density of EPNs is similar to that of glioblastoma.[18] EPNs overexpress VEGF and VEGFRs, which has been correlated with poor survival.[4,5] The VEGF-neutralizing antibody bevacizumab has been shown to demonstrate no efficacy in pediatric rEPNs.[19] Other clinical studies have reported a lack of efficacy of bevacizumab in association with irinotecan[20] and lapatinib.[21] Sunitinib, a small multitarget TKI that inhibits VEGFR, PDGRF, and c-Kit, also failed to show activity.[22] The efficacy of targeted drugs in these patients is disappointing.