title: Antiangiogenic agents in gynecological cancer: State of art and perspectives of clinical research.
abstract: Vascular endothelial growth factor [VEGF] pathway, which plays a key role in angiogenesis, may be blocked by either extracellular interference with VEGF itself (bevacizumab [BEV] or aflibercept), or intracytoplasmic inhibition of VEGF receptor (pazopanib, nintedanib, cediranid, sunitinib and sorafenib). An alternative approach is represented by trebananib, a fusion protein that prevents the interaction of angiopoietin [Ang]-1 and Ang-2 with Tie2 receptor on vascular endothelium. The combination of antiangiogenic agents, especially BEV, and chemotherapy is a rational therapeutic option for primary or recurrent ovarian carcinoma. However, it will be difficult to accept that it represents the new standard treatment, until biological characterization of ovarian carcinoma has not identified subsets of tumors with different responsiveness to BEV. Anti-angiogenesis is an interesting target also for recurrent cervical or endometrial cancer, but nowadays the use of anti-angiogenic agents in these malignancies should be reserved to patients enrolled in clinical trials.
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy. Electronic address: a.gadducci@obgyn.med.unipi.it.
authors.forename: Angiolo
authors.initials: A
authors.lastname: Gadducci
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy.
authors.forename: Nora
authors.initials: N
authors.lastname: Lanfredini
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Gynecology and Obstetrics, University of Pisa, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sergiampietri
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C551398:trebananib
keywords: Bevacizumab; Cervical cancer; Endometrial cancer; Epithelial ovarian cancer; Molecular signatures; Nintedanib; Pazopanib; Trebanabib