Angiogenesis in cancer: molecular mechanisms, clinical impact.
BACKGROUND
Angiogenesis, the formation of new blood vessels from the endothelium of the existing vasculature, is fundamental in tumor growth, progression, and metastasis. Inhibiting tumor angiogenesis is a promising strategy for treatment of cancer and has been successfully transferred from preclinical to clinical application in recent years. Whereas conventional therapeutic approaches, e.g. chemotherapy and radiation, are focussing on tumor cells, antiangiogenic therapy is directed against the tumor supplying blood vessels.


METHODS
This review will summarize important molecular mechanisms of tumor angiogenesis and advances in the design of antiangiogenic drugs. Furthermore, clinical implications of antiangiogenic therapy in surgical oncology will be discussed.


RESULTS
First antiangiogenic drugs have been approved for treatment of advanced solid tumors in several countries. Leading antiangiogenic drugs are designed to inhibit vascular endothelial growth factor-mediated tumor angiogenesis. Combining antiangiogenic agents with conventional chemotherapy or radiation is currently investigated clinically with great emphasis to realize a multimodal tumor therapy, targeting both the tumor cell and tumor vascular compartment.


CONCLUSIONS
Antiangiogenic tumor therapy represents a promising strategy for treatment of cancer and will most likely exhibit its clinical potential in combination with established standard tumor therapies in the future.
Eichhorn
M E
ME
Department of Surgery, Klinikum Grosshadern, University of Munich, Marchioninistr. 15, 80337 Munich, Germany.
Kleespies
A
A
Angele
M K
MK
Jauch
K-W
KW
Bruns
C J
CJ
D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D042501:Angiogenic Proteins / Q000502:physiology; D001557:Benzenesulfonates / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000188:drug therapy; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D008833:Microcirculation / Q000187:drug effects / Q000473:pathology; D009369:Neoplasms / Q000098:blood supply* / Q000188:drug therapy; D009389:Neovascularization, Pathologic / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D000077157:Sorafenib; D000077210:Sunitinib
D020533:Angiogenesis Inhibitors; D042501:Angiogenic Proteins; D001557:Benzenesulfonates; D007211:Indoles; D010671:Phenylurea Compounds; D011725:Pyridines; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib