Antiangiogenesis strategies revisited: from starving tumors to alleviating hypoxia

Area of Science:

• Oncology
• Vascular Biology
• Cancer Therapeutics

Background:

• Antiangiogenic drugs targeting VEGF are approved for cancer treatment.
• These drugs can induce tumor hypoxia, potentially promoting tumor progression and resistance.
• Clinical data suggest improved perfusion/oxygenation correlates with better patient survival.

Purpose of the Study:

• To summarize lessons from antiangiogenic therapy research over the past decade.
• To propose strategies for improving antiangiogenic therapy outcomes.
• To address outcomes in both malignant and nonmalignant diseases.

Main Methods:

• Review of preclinical and clinical studies on antiangiogenic therapy.
• Analysis of the relationship between antiangiogenic agents, tumor hypoxia, and perfusion.
• Synthesis of data to inform therapeutic strategies.

Main Results:

• Antiangiogenic therapy can paradoxically increase tumor hypoxia.
• Improved tumor perfusion and oxygenation are associated with longer survival.
• Hypoxia can drive tumor progression and treatment resistance.

Conclusions:

• Alleviating tumor hypoxia is crucial for enhancing antiangiogenic therapy.
• Strategies improving perfusion and oxygenation may boost radiotherapy, chemotherapy, and immunotherapy.
• Optimized antiangiogenic approaches hold promise for treating various diseases.