title: Tumor resistance to vascular disrupting agents: mechanisms, imaging, and solutions.
abstract: The emergence of vascular disrupting agents (VDAs) is a significant advance in the treatment of solid tumors. VDAs induce rapid and selective shutdown of tumor blood flow resulting in massive necrosis. However, a viable marginal tumor rim always remains after VDA treatment and is a major cause of recurrence. In this review, we discuss the mechanisms involved in the resistance of solid tumors to VDAs. Hypoxia, tumor-associated macrophages, and bone marrow-derived circulating endothelial progenitor cells all may contribute to resistance. Resistance can be monitored using magnetic resonance imaging markers. The various solutions proposed to manage tumor resistance to VDAs emphasize combining these agents with other approaches including antiangiogenic agents, chemotherapy, radiotherapy, radioimmunotherapy, and sequential dual-targeting internal radiotherapy.
authors.affiliation: Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Liang
authors.affiliation: Radiology Section, University Hospitals, University of Leuven, Leuven, Belgium.
authors.forename: Yicheng
authors.initials: Y
authors.lastname: Ni
authors.affiliation: Department of Radiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
mesh_terms: D020533:Angiogenesis Inhibitors; D000818:Animals; D019008:Drug Resistance, Neoplasm; D006801:Humans; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000188:drug therapy
chemical_list: D020533:Angiogenesis Inhibitors
keywords: imaging; resistance; solutions; vascular disrupting agents
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