Angiogenesis and Breast Cancer: What next?
Angiogenesis remains a critical feature of tumor evolvement and metastasis. Therefore blocking angiogenesis is very appealing as a pathway to curing cancer. Since angiogenesis is a complex mechanism where pro and anti-angiogenesis factors compete, multiple possibilities have been postulated to interfere with this tumor-induced neovascularization process.
The most studied approach in the field of breast cancer so far has been the use of bevacizumab, a humanized monoclonal antibody directed against the most potent pro-angiogenic factor, the vascular endothelial growth factor (VEGF). Bevacizumab has been shown to be active in several malignancies, in particular colo-rectal cancer and was launched in breast cancer in early as well as late stages. Other anti-angiogenic drugs like sorafenib, sunitinib and ramicurimab have also been extensively studied. The studies so far have had sobering results that did not match the early expectations from the preclinical setting.Nearly 4 decades after Folkman first introduced neovascularization, interest in inhibition of angiogenesis in the breast cancer field seems to be fading away after several disappointing studies. In this review we summarize successes and challenges of anti-angiogenic therapy and highlight the pivotal clinical trials of anti-angiogenic drugs in the breast cancer field.
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