New paradigms for the treatment of cancer: the role of anti-angiogenesis agents.
Angiogenesis, the sprouting of new blood vessels, plays a role in diverse disease states including cancer, diabetic retinopathy, age-related macular degeneration, rheumatoid arthritis, psoriasis, atherosclerosis, and restenosis. With regard to cancer, the clinical association of tumor vascularity with tumor aggressiveness has been clearly demonstrated in numerous tumor types. The observation of increased microvessel density in tumors not only serves as an independent prognostic indicator, but also suggests that anti-angiogenic therapy may be an important component of treatment regimens for cancer patients. The complexity of the angiogenic process, which involves both positive and negative regulators, provides a number of targets for therapy. Many positive regulators, including growth factor receptors, matrix metalloproteinases, and integrins, have been correlated with increased vascularity of tumors and poor prognosis for patient survival. Thus, these serve as ideal targets for anti-angiogenesis therapy. Many inhibitors of these targets are currently undergoing clinical evaluation as potential anti-cancer agents. In this article, we discuss the role of positive regulators in angiogenesis and tumor growth and describe the anti-angiogenic agents under development.
Cherrington
J M
JM
SUGEN, Inc., South San Francisco, CA 94080, USA.
Strawn
L M
LM
Shawver
L K
LK
D020533:Angiogenesis Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D002352:Carrier Proteins / Q000502:physiology; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000502:physiology; D015195:Drug Design; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D005341:Fibrinolysin / Q000502:physiology; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D016023:Integrins / Q000037:antagonists & inhibitors / Q000502:physiology; D008666:Metalloendopeptidases / Q000502:physiology; D051379:Mice; D008819:Mice, Nude; D009362:Neoplasm Metastasis; D009363:Neoplasm Proteins / Q000502:physiology; D009369:Neoplasms / Q000098:blood supply / Q000628:therapy*; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D010960:Plasminogen Activators / Q000502:physiology; D011480:Protease Inhibitors / Q000494:pharmacology; D020794:Receptor Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000502:physiology; D017978:Receptors, Growth Factor / Q000187:drug effects / Q000502:physiology; D013939:Thymidine Phosphorylase / Q000502:physiology
D020533:Angiogenesis Inhibitors; D002352:Carrier Proteins; D016207:Cytokines; D016326:Extracellular Matrix Proteins; D006133:Growth Substances; D016023:Integrins; D009363:Neoplasm Proteins; D011480:Protease Inhibitors; D017978:Receptors, Growth Factor; C066845:pleiotrophin; D013939:Thymidine Phosphorylase; D020794:Receptor Protein-Tyrosine Kinases; D010960:Plasminogen Activators; D005341:Fibrinolysin; D008666:Metalloendopeptidases