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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Angiogenesis is defined as the formation of new blood vessels from a pre-existing vascular bed. By supplying nutrients and oxygen and removing waste products in malignant tumors, it is an essential process that regulates cancer growth and dissemination. This process is regulated by both pro- and antiangiogenic compounds. Vascular endothelial growth factor is one of the most important and best-studied proangiogenic factors. Bevacizumab, a monoclonal antibody against vascular endothelial growth factor, has been shown to inhibit angiogenesis and is proving to be of clinical benefit in a variety of tumor types. The strongest evidence comes from studies in advanced colorectal and non-small-cell lung cancer, with growing evidence in breast and epithelial ovarian tumors. The duration and timing of bevacizumab's use is currently the focus of several ongoing clinical trials.
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PMID:Bevacizumab in the management of solid tumors. 1742 64

Tumor angiogenesis is essential for the growth and metastasis of solid tumors. In breast cancer, increased levels of vascular endothelial growth factor (VEGF) have been associated with poor prognosis in lymph node-positive and lymph node-negative patients. In addition to its prognostic significance, VEGF is now a validated target in the treatment of breast cancer. Bevacizumab, an anti-VEGF antibody, has demonstrated significant clinical benefit in several solid tumors. In this article the authors discuss the data pertaining to bevacizumab and other antiangiogenic agents for the treatment of patients who have advanced breast cancer.
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PMID:Bevacizumab for advanced breast cancer. 1751 51

Human tumors are dependent on angiogenesis for growth, and the vascular endothelial growth factor (VEGF) is a major regulator of this process. Bevacizumab (Avastin), a monoclonal antibody directed against VEGF, has shown promise in treating a variety of cancers. In this study, we first examined the anti-tumor effects of bevacizumab on head and neck squamous cell carcinoma (HNSCC). Then we examined the effects of bevacizumab combined with paclitaxel, a chemotherapeutic agent, in HNSCC. This is the first demonstration of the anti-tumor effects of bevacizumab on HNSCC. In vitro, bevacizumab did not show any antiproliferative effects against the HNSCC cell lines. However, in vivo, bevacizumab showed dramatic anti-tumor effects against HNSCC tumor xenografts in mice. In addition, treatment with a bevacizumab-paclitaxel combination resulted in a remarkable inhibition of the HNSCC tumor xenografts, compared to the effects of each agent separately. A decreased blood vessel density and an increased apoptotic index were seen in the shrunken tumors. These results suggest that bevacizumab in combination with paclitaxel could have useful clinical application in HNSCC.
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PMID:Anti-tumor effects of bevacizumab in combination with paclitaxel on head and neck squamous cell carcinoma. 1754 44

Neo-angiogenesis appears to be a critical feature of tumor growth, migration, and metastasis. Therefore, inhibition of angiogenesis is an appealing strategy for treatment of cancer. Since angiogenesis is the result of several mechanistic processes, controlled by numerable pro- and anti-angiogenic factors and their receptors, multiple possibilities to prevent or reverse tumor-induced neo-vascularization have been proposed. Of these, currently, the most promising approach has been the use of bevacizumab, a humanized monoclonal antibody directed against the most potent pro-angiogenic factor, vascular endothelial growth factor (VEGF). Bevacizumab has been shown to be active in several malignancies, in particular colo-rectal cancer. Although early studies of bevacizumab in far-advanced metastatic breast cancer were disappointing, the results of a recently reported clinical trial by the Eastern Oncology Group comparing first line paclitaxel with or without bevacizumab has demonstrated statistically significant improvements in response rates and time progression. Ongoing studies are now investigating the benefits of bevacizumab with other chemotherapeutic and biologic agents in early metastatic disease as well as in the adjuvant setting. Other anti-angiogenic agents remain in early clinical trials. Small molecular inhibitors of VEGF receptor tyrosine kinase activity, such as sunitinib, appear promising. Nearly 40 years after it was first proposed, inhibition of angiogenesis appears to be gaining a role in medical oncology.
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PMID:Angiogenesis as targeted breast cancer therapy. 1770 41

For many years, oncology research has focused on the study of therapeutic agents able to target a different cell than a cancer cell. Tumor angiogenesis mediated by the vascular endothelial growth factor (VEGF) was one of the pathways investigated. The treatment of metastastic colorectal cancer has dramatically evolved. Overall survival has significantly improved, owing to the use in standard daily practice of irinotecan and oxaliplatin, combined with 5-fluorouracil (5FU) and leucovorin. This review summarizes efficacy and safety data of two antiangiogenic agents, bevacizumab (a monoclonal antibody inhibiting VEGF) and vatalanib (a tyrosine kinase inhibitor of VEGF), assessed in phase III trials in metastastic colorectal cancer. The efficacy of bevacizumab combined with 5FU-leucovorin +/- irinotecan based on overall survival data which was demonstrated in the first-line treatment of metastastic colorectal cancer in studies conducted in the US, has recently been demonstrated in the same indication based on progression survival when combined to oxaliplatin and a fluoropyrimidine (capecitabine or 5FU-leucovorin). Bevacizumab combined to infusion chemotherapy with 5FU-leucovorin with or without irinotecan is indicated, in Europe, in the first-line treatment of metastastic colorectal cancer. While in the US, prescription options are wider in the first-line treatment, it is combined to chemotherapies with a fluoropyrimidine +/- irinotecan or oxaliplatin, and in second line as well with fluoropyrimidine and oxaliplatin. Several questions regarding the optimal use of bevacizumab still remain to be answered in the treatment of metastastic colorectal cancer. Vatalanib has not shown benefit in this pathology.
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PMID:[Anti-angiogenic treatment and colorectal cancer]. 1784 7

The approval in 2004 of bevacizumab (Avastin), a neutralizing monoclonal antibody directed against vascular endothelial growth factor (VEGF) as the first anti-angiogenic systemic drug to treat cancer patients validated the notion introduced 33 years earlier by Dr. Judah Folkman, that inhibition of tumor angiogenesis might be a valid approach to control tumor growth. Anti-angiogenic therapy was greeted in the clinic a major step forward in cancer treatment. At the same time this success recently boosted the field to the quest for new anti-angiogenic targets and drugs. In spite of this success, however, some old questions in the field have remained unanswered and new ones have emerged. They include the identification for surrogate markers of angiogenesis and anti-angiogenesis, the understanding about how anti-angiogenic therapy and chemotherapy synergize, the characterization of the biological consequences of sustained suppression of angiogenesis on tumor biology and normal tissue homeostasis, and the mechanisms of tumor escape from anti-angiogenesis. In this review we summarize some of these outstanding questions, and highlight future challenges in clinical, translational and experimental research in anti-angiogenic therapy that need to be addressed in order to improve current treatments and to design new drugs.
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PMID:Anti-angiogenic therapies in cancer: achievements and open questions. 1787 94

Epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) are often overexpressed in colorectal cancer and are associated with inferior outcomes. Based on successful randomized phase III trials, anti-EGFR and anti-VEGF therapeutics have entered clinical practice. Cetuximab (Erbitux), an EGFR-specific antibody, is currently approved in the United States in combination with irinotecan (Camptosar) for patients with metastatic colorectal cancer refractory to irinotecan or as a single agent for patients unable to tolerate irinotecan-based therapy. In retrospective analyses, patients with EGFR-expressing rectal cancer undergoing neoadjuvant radiation therapy had a significantly inferior disease-free survival and lower rates of achieving pathologic complete response. Based on the positive data in metastatic colorectal cancer and synergy with radiation therapy seen in preclinical models, there is a strong rationale to combine cetuximab with neoadjuvant radiation therapy and chemotherapy in rectal cancer. Bevacizumab (Avastin), a VEGF-specific antibody, was the first antiangiogenic agent to be approved in the United States for use in combination with standard chemotherapy in the first- and second-line of treatment in metastatic colorectal cancer. VEGF-targeted therapy may lead to indirect killing of cancer cells by damaging tumor blood vessels, and may increase the radiosensitivity of tumor-associated endothelial cells. VEGF blockade can also "normalize" tumor vasculature, thereby leading to greater tumor oxygenation and drug penetration. This review will address completed and ongoing trials that have established and continue to clarify the effects of these agents in rectal cancer.
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PMID:Targeted therapy in rectal cancer. 1791 Mar 11

The majority of non-small cell lung cancer (NSCLC) patients present with advanced disease, and despite the improvement in efficacy and safety outcomes with platinum-based chemotherapy, this standard cytotoxic approach has reached a therapeutic plateau, with the prognosis for this clinical condition remaining poor. Advances in the knowledge of tumor biology and mechanisms of oncogenesis have granted the singling out of several molecular targets for NSCLC treatment. Bevacizumab, an anti-growth factor vascular endothelial growth factor (VEGF) monoclonal antibody, is the antiangiogenic agent at the most advanced stage of development in the treatment of solid tumors and also in NSCLC treatment. Bevacizumab, combined with platinum-based chemotherapy, has been demonstrated to improve efficacy outcomes over chemotherapy alone in the treatment of nonsquamous advanced NSCLC in two phase III randomized trials. These represent the first evidence of improvement in treatment outcomes of chemotherapy with targeted therapies in the first-line treatment of advanced NSCLC. Future clinical developments of bevacizumab in NSCLC treatment will include the combination of this agent with other targeted therapies in advanced disease (especially with erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor) and the integration of this agent into combined modality approaches for the treatment of early-stage and locally advanced disease.
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PMID:The role of bevacizumab in the treatment of non-small cell lung cancer: current indications and future developments. 1796 12

Sunitinib is a highly potent, selective vascular endothelial growth factor-receptor types 1 to 3, platelet-derived growth factor (PDGF)-R-alpha, and PDGF-R-ss. Preclinical data suggest that sunitinib (SU11248) has antitumor activity that may result from both inhibition of angiogenesis and direct antiproliferative effects on certain tumor cell types. Sunitinib resulted in tumor shrinkage in 80% of patients who had failed treatment with Bevacizumab and 13% of patients demonstrated an objective Response Evaluation Criteria in solid Tumors (RECIST) in a study presented at the 2006 American Society of Clinical Oncology (ASCO) meeting. We report the first published pathological evidence of sunitinib's effect on recurrent renal cell carcinoma. This was seen in a patient with renal cell carcinoma who developed a renal fossa recurrence 2 years following radical nephrectomy. Tumor shrinkage was evident in the nephrectomy bed after treatment with sunitinib. The pathology of the resected retroperitoneal mass and its implications are discussed.
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PMID:Pathological evidence of necrosis in recurrent renal mass following treatment with sunitinib. 1803 49

Photodynamic therapy (PDT) is a therapeutic modality in which a photosensitizer is locally or systemically administered followed by light irradiation of suitable wavelength to achieve selective tissue damage. In addition, PDT is an oxygen-consuming reaction, that causes hypoxia mediated destruction of tumor vasculature that results in effective treatment. However, the hypoxic condition within tumors can cause stress-related release of angiogenic growth factors and cytokines and this inflammatory response could possibly diminish the efficacy of PDT by promoting tumor regrowth. In such circumstances, PDT effectiveness can be enhanced by combining angiogenesis inhibitors into the treatment regimen. Avastin (bevacizumab), a vascular endothelial growth factor (VEGF) specific monoclonal antibody in combination with chemotherapy is offering hope to patients with metastatic colorectal cancer. In this study we evaluated the combination of hypericin-mediated PDT and Avastin on VEGF levels as well as its effect on overall tumor response. Experiments were conducted on bladder carcinoma xenografts established subcutaneously in Balb/c nude mice. Antibody array, enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry (IHC) were performed to assess VEGF concentrations in the various treatment groups. Our results demonstrated that the targeted therapy by Avastin along with PDT can improve tumor responsiveness in bladder tumor xenografts. Immunostaining showed minimal expression of VEGF in tumors treated with combination therapy of PDT and Avastin. Angiogenic proteins e.g., angiogenin, basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) and interleukins (IL-6 and IL-8) were also found to be downregulated in groups treated with combination therapy.
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PMID:Hypericin-mediated photodynamic therapy in combination with Avastin (bevacizumab) improves tumor response by downregulating angiogenic proteins. 1804 82


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