Novel strategy of anti-angiogenic therapy for uterine cervical carcinomas

In uterine cervical carcinomas, lymph node metastasis, recognized as a common form of metastasis, and recurrence after curative resection are critical to patient prognosis. The growth of secondarily spreading and initial recurrent lesions must be suppressed to improve patient prognosis. Chemotherapy and radiation are often not very specific to cancer cells and produce severe effects on normal cells, especially bone marrow and renal cells. On the other hand, anti-angiogenic therapy is specific to the rapidly growing vascular endothelial cells in tumors, without any effect on slow growing vascular endothelial cells and other normal cells. Therefore, anti-angiogenic therapy should be an excellent strategy to suppress the growth of secondarily spreading and initial recurrent lesions. However, if a particular angiogenic factor is suppressed by anti-angiogenic therapy for a long period, another angiogenic factor may be induced by linked alternative angiogenic pathway, a process recognized as tolerance. The angiogenic factor expression and the effects of angiogenic transcription factors in uterine cervical carcinomas are herein reviewed and novel therapeutic trends are introduced.