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Trends and Challenges in Tumor Anti-Angiogenic Therapies

1
Institute of Anatomy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden School of Medicine, 01307 Dresden, Germany
2
German Cancer Consortium (DKTK), Partner Site Dresden, 01307 Dresden, Germany
3
German Cancer Research Center (DKFZ), 61920 Heidelberg, Germany
*
Author to whom correspondence should be addressed.
Received: 12 July 2019 / Revised: 9 September 2019 / Accepted: 14 September 2019 / Published: 18 September 2019
(This article belongs to the Special Issue Angiogenesis in Cancer)
Excessive abnormal angiogenesis plays a pivotal role in tumor progression and is a hallmark of solid tumors. This process is driven by an imbalance between pro- and anti-angiogenic factors dominated by the tissue hypoxia-triggered overproduction of vascular endothelial growth factor (VEGF). VEGF-mediated signaling has quickly become one of the most promising anti-angiogenic therapeutic targets in oncology. Nevertheless, the clinical efficacy of this approach is severely limited in certain tumor types or shows only transient efficacy in patients. Acquired or intrinsic therapy resistance associated with anti-VEGF monotherapeutic approaches indicates the necessity of a paradigm change when targeting neoangiogenesis in solid tumors. In this context, the elaboration of the conceptual framework of “vessel normalization” might be a promising approach to increase the efficacy of anti-angiogenic therapies and the survival rates of patients. Indeed, the promotion of vessel maturation instead of regressing tumors by vaso-obliteration could result in reduced tumor hypoxia and improved drug delivery. The implementation of such anti-angiogenic strategies, however, faces several pitfalls due to the potential involvement of multiple pro-angiogenic factors and modulatory effects of the innate and adaptive immune system. Thus, effective treatments bypassing relapses associated with anti-VEGF monotherapies or breaking the intrinsic therapy resistance of solid tumors might use combination therapies or agents with a multimodal mode of action. This review enumerates some of the current approaches and possible future directions of treating solid tumors by targeting neovascularization. View Full-Text
Keywords: anti-angiogenesis therapy of cancer; sprouting angiogenesis; stromal microenviroment; evasive resistance; vessel normalization; anti-VEGF therapy; Bevacizumab; Aflibercept; small-molecule multikinase-inhibitors; angiogenesis inhibitors anti-angiogenesis therapy of cancer; sprouting angiogenesis; stromal microenviroment; evasive resistance; vessel normalization; anti-VEGF therapy; Bevacizumab; Aflibercept; small-molecule multikinase-inhibitors; angiogenesis inhibitors
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MDPI and ACS Style

Jászai, J.; Schmidt, M.H.H. Trends and Challenges in Tumor Anti-Angiogenic Therapies. Cells 2019, 8, 1102. https://0-doi-org.brum.beds.ac.uk/10.3390/cells8091102

AMA Style

Jászai J, Schmidt MHH. Trends and Challenges in Tumor Anti-Angiogenic Therapies. Cells. 2019; 8(9):1102. https://0-doi-org.brum.beds.ac.uk/10.3390/cells8091102

Chicago/Turabian Style

Jászai, József; Schmidt, Mirko H.H. 2019. "Trends and Challenges in Tumor Anti-Angiogenic Therapies" Cells 8, no. 9: 1102. https://0-doi-org.brum.beds.ac.uk/10.3390/cells8091102

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