Angiogenesis: Promising Therapeutic Target of Metastatic Colon Cancer

Colon cancer (CC) is the third most diagnosed cancers globally and second most lethal malignancy in both men and women due to aggressive metastatic ability. Genetic or somatic mutations causes the transformation of normal epithelium of colon into precancerous stage and eventually to metastatic phenotype in nearly 10 to 15 years. This progression is depending heavily on the tumor induced angiogenesis, which significantly impact the survival of the patients. Angiogenesis is majorly promoted by hypoxia, growth factors, macrophages, and non-coding RNAs as well as distinct signaling pathways in metastatic CCs. Blocking of antiangiogenic pathway using phytochemicals, small molecules, synthetic derivatives alone or along with chemotherapeutics substantially enhanced disease control as well as overall survival of patients with metastatic CC in second line treatment. Further, clinical trials showed benefit of adjuvant chemotherapeutics for treating metastatic CC patients. This chapter attempts to summarize the recent updates of angiogenic promotes of metastatic CC and targeted therapeutics for adjuvant therapy in clinical trials.