Angiopoietins and non-vascular endothelial growth factor antiangiogenic targets in advanced renal cell carcinoma

Stephen L Richey1, Thomas E Hutson

  • 1Hematology and Oncology, Texas Oncology Fort Worth, Fort Worth, TX, USA.

Insights

Metastatic renal cell carcinoma treatment has shifted to antiangiogenesis agents, improving survival. However, resistance necessitates exploring new targets like angiopoietin, fibroblast growth factor, and platelet-derived growth factor pathways.

Area of Science:

  • Oncology
  • Cancer Biology
  • Translational Medicine

Background:

  • Metastatic renal cell carcinoma (mRCC) treatment has advanced from immune modulation to antiangiogenesis therapies.
  • Vascular endothelial growth factor (VEGF) and mammalian target of rapamycin (mTOR) pathway inhibitors have significantly improved patient survival.
  • Acquired resistance to current therapies limits long-term efficacy in kidney cancer.

Purpose of the Study:

  • To review emerging antiangiogenic targets for mRCC.
  • To discuss novel therapeutic strategies to overcome treatment resistance.
  • To explore alternative angiogenesis pathways for improved kidney cancer outcomes.

Main Methods:

  • Literature review of current and investigational mRCC treatments.
  • Analysis of resistance mechanisms to antiangiogenesis and mTOR inhibitors.
  • Identification of alternative angiogenic pathways as therapeutic targets.

Main Results:

  • Current mRCC treatments primarily target VEGF and mTOR pathways.
  • Resistance to these targeted therapies is a significant clinical challenge.
  • Several alternative pathways, including angiopoietins, FGF, and PDGF, show promise.

Conclusions:

  • Overcoming resistance in mRCC requires novel therapeutic approaches.
  • Targeting alternative angiogenesis pathways offers a promising strategy for future kidney cancer treatment.
  • Investigational agents targeting angiopoietin, FGF, and PDGF families warrant further clinical evaluation.

Related Concept Videos

Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Regulation of Angiogenesis and Blood Supply01:24

Regulation of Angiogenesis and Blood Supply

Rapidly dividing tumors, embryos, and wounded tissues require more oxygen than usual, lowering the oxygen concentration in the blood. At low oxygen or hypoxic conditions, an oxygen-sensitive transcription factor called the hypoxia-inducible factor 1 or HIF1 is activated. HIF1 is a dimeric protein of alpha (ɑ) and beta (β) subunits.  Under optimal oxygen conditions, HIF1β is present in the nucleus while HIF1ɑ remains in the cytosol. HIF1ɑ is hydroxylated by prolyl hydroxylase and factor...
Mechanism of Angiogenesis01:10

Mechanism of Angiogenesis

Blood vessel formation starts early during embryonic development, around day 7. In the extraembryonic yolk sac, mesodermal precursor cells called hemangioblast proliferate and differentiate into angioblast. Angioblasts express vascular endothelial growth factor receptor 2 or VEGFR2, which binds VEGF-A, a proangiogenic factor, guiding blood vessel formation. VEGF signaling promotes angioblasts to form a blood island in the developing embryo. Angioblasts further differentiate, giving rise to...
Non-Canonical Wnt Signaling Pathways01:41

Non-Canonical Wnt Signaling Pathways

Wnt is a zygotic effect gene that is expressed during very early embryonic development. It regulates various processes in animals starting from early development through the adult stage, such as organogenesis in the embryo and maintenance of neuronal and blood stem cells. Wnt proteins can induce a wide variety of intracellular pathways depending upon the specific abilities of different Wnt ligands to form a complex with shared and cognate receptors in the presence of different co-receptors. The...
mTOR Signaling and Cancer Progression03:03

mTOR Signaling and Cancer Progression

The mammalian target of rapamycin or mTOR protein was discovered in 1994 due to its direct interaction with rapamycin. The protein gets its name from a yeast homolog called TOR. The mTOR protein complex in mammalian cells plays a major role in balancing anabolic processes such as the synthesis of proteins, lipids, and nucleotides and catabolic processes, such as autophagy in response to environmental cues, such as availability of nutrients and growth factors.
The mTOR pathway or the...
Mitogens and the Cell Cycle02:38

Mitogens and the Cell Cycle

Mitogens and their receptors play a crucial role in controlling the progression of the cell cycle. However, the loss of mitogenic control over cell division leads to tumor formation. Therefore, mitogens and mitogen receptors play an important role in cancer research. For instance, the epidermal growth factor (EGF) - a type of mitogen and its transmembrane receptor (EGFR), decides the fate of the cell's proliferation. When EGF binds to EGFR, a member of the ErbB family of tyrosine kinase...