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Updated: May 9, 2026

Isolation and Culture Expansion of Tumor-specific Endothelial Cells
Published on: October 14, 2015
Changes in tumour vessel density upon treatment with anti-angiogenic agents: relationship with response and
N S Vasudev1, V Goh, J K Juttla
1Tumour Biology Team, Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK.
Background:
We examine how changes in a surrogate marker of tumour vessel density correlate with response and resistance to anti-angiogenic therapy.
Methods:
In metastatic renal cancer patients treated with anti-angiogenic tyrosine kinase inhibitors, arterial phase contrast-enhanced computed tomography was used to simultaneously measure changes in: (a) tumour size, and (b) tumour enhancement (a surrogate marker of tumour vessel density) within individual lesions.
Results:
No correlation between baseline tumour enhancement and lesion shrinkage was observed, but a reduction in tumour enhancement on treatment was strongly correlated with reduction in lesion size (r=0.654, P<0.0001). However, close examination of individual metastases revealed different types of response: (1) good vascular response with significant tumour shrinkage, (2) good vascular response with stabilisation of disease, (3) poor vascular response with stabilisation of disease and (4) poor vascular response with progression. Moreover, contrasting responses between different lesions within the same patient were observed. We also assessed rebound vascularisation in tumours that acquired resistance to treatment. The amplitude of rebound vascularisation was greater in lesions that had a better initial response to therapy (P=0.008).
Interpretation:
Changes in a surrogate marker of tumour vessel density correlate with response and resistance to anti-angiogenic therapy. The data provide insight into the mechanisms that underlie response and resistance to this class of agent.
Insights
Tumor enhancement changes correlate with treatment response and resistance in patients receiving anti-angiogenic therapy. Reduced enhancement indicates tumor shrinkage, while rebound vascularization suggests acquired resistance.
Area of Science:
- Oncology
- Radiology
- Pharmacology
Background:
- Investigating tumor vessel density as a marker for anti-angiogenic therapy response.
- Assessing correlation between tumor enhancement and treatment outcomes.
Purpose of the Study:
- To correlate changes in tumor vessel density with response and resistance to anti-angiogenic therapy.
- To understand mechanisms of response and resistance to tyrosine kinase inhibitors.
Main Methods:
- Arterial phase contrast-enhanced CT in metastatic renal cancer patients.
- Simultaneous measurement of tumor size and enhancement (tumor vessel density surrogate).
- Analysis of individual lesion responses and rebound vascularization.
Main Results:
- Reduced tumor enhancement strongly correlated with lesion size reduction.
- Observed diverse responses within individual lesions and across patients.
- Rebound vascularization amplitude was greater in lesions with better initial response.
Conclusions:
- Tumor enhancement changes serve as a surrogate marker for anti-angiogenic therapy response and resistance.
- Provides insights into the mechanisms of action and resistance to anti-angiogenic agents.
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