Related Experiment Video

Updated: Jan 24, 2026

Transfer of Manipulated Tumor-associated Neutrophils into Tumor-Bearing Mice to Study their Angiogenic Potential In Vivo
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Transfer of Manipulated Tumor-associated Neutrophils into Tumor-Bearing Mice to Study their Angiogenic Potential In Vivo

Published on: July 20, 2019

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Limitations of Anti-Angiogenic Treatment of Tumors

Domenico Ribatti1, Tiziana Annese1, Simona Ruggieri1

  • 1Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy.

Translational Oncology
|May 24, 2019
PubMed

Insights

Anti-angiogenic therapies show limited survival benefits. This review explores tumor traits like genetic changes and vascular mimicry that hinder anti-VEGF effectiveness, suggesting combination therapies for better outcomes.

Area of Science:

  • Oncology
  • Cancer Biology
  • Tumor Microenvironment

Background:

  • Anti-vascular endothelial growth factor (VEGF) therapies offer modest survival improvements in cancer treatment.
  • Tumor responses to anti-angiogenic agents are variable, necessitating a deeper understanding of resistance mechanisms.
  • The tumor microenvironment and cellular interactions significantly influence therapeutic efficacy.

Purpose of the Study:

  • To review tumor characteristics and processes that compromise anti-angiogenic therapy effectiveness.
  • To highlight the role of the hypoxic tumor microenvironment and tumor-infiltrating cells.
  • To discuss novel therapeutic strategies, including immunotherapy combinations.

Main Methods:

  • Literature review of clinical trials and preclinical studies on anti-angiogenic therapies.
  • Analysis of tumor-specific factors influencing treatment response.
  • Exploration of emerging therapeutic combinations targeting tumor vasculature.

Main Results:

  • Tumor genotypic changes, vascular normalization, and vasculogenic mimicry can limit anti-VEGF efficacy.
  • Anti-angiogenic treatment can induce a hypoxic microenvironment, potentially increasing tumor invasiveness.
  • Tumor-associated macrophages (TAMs) and fibroblasts (TAFs) play a crucial role in anti-angiogenic therapy response.

Conclusions:

  • Understanding resistance mechanisms is key to improving anti-angiogenic therapy outcomes.
  • Combining anti-angiogenic therapy with agents like anti-PD-1/anti-PD-L1 may enhance efficacy and prolong survival.
  • Targeting tumor vasculature requires a multifaceted approach considering tumor biology and immune interactions.

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