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Antiangiogenic Tyrosine Kinase Inhibitors in Metastatic Colorectal Cancer: Focusing on Regorafenib
Marios Papadimitriou1, Christos A Papadimitriou2
1Oncology Unit, Second Department of Surgery, "Aretaieion" University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Abstract:
The progress of metastatic colorectal cancer (mCRC) depends essentially on two signaling pathways: the first mediated by vascular endothelial growth factor (VEGF) and the second by epidermal growth factor receptor (EGFR). In colorectal cancer (CRC), the balance between pro-angiogenic and anti-angiogenic factors is disturbed in favor of a pro-angiogenic outcome (angiogenic switch) early in the neoplastic progression of adenomas, thus, resulting in neovascularization and eventually in malignant tumor progression. Furthermore, angiogenesis plays an important role in tumor growth and the formation of metastases. Several angiogenic growth factors have been identified to be highly expressed during the progression and metastatic spread of CRC, but VEGFA is the predominant angiogenic cytokine and the most consistently expressed factor during the metastatic process. Agents targeting VEGF/VEGFR signaling have shown efficacy in the treatment of mCRC and are currently approved in this setting. In this review, we summarize the role of antiangiogenic tyrosine kinase inhibitors (TKIs) in the treatment of mCRC, focusing on regorafenib.
Insights
Metastatic colorectal cancer (mCRC) progression involves VEGF and EGFR pathways. Antiangiogenic therapies targeting VEGF/VEGFR signaling, like regorafenib, show efficacy in treating mCRC.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Metastatic colorectal cancer (mCRC) progression is driven by key signaling pathways, including vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR).
- An imbalance favoring pro-angiogenesis (angiogenic switch) occurs early in colorectal cancer (CRC) development, promoting neovascularization and tumor progression.
- VEGF-A is a critical cytokine in CRC angiogenesis, tumor growth, and metastasis.
Purpose of the Study:
- To review the role of antiangiogenic tyrosine kinase inhibitors (TKIs) in mCRC treatment.
- To highlight the efficacy of regorafenib as a targeted therapy for mCRC.
Main Methods:
- Review of scientific literature on angiogenesis in CRC.
- Analysis of clinical data for antiangiogenic agents targeting VEGF/VEGFR signaling.
- Focus on tyrosine kinase inhibitors (TKIs) including regorafenib.
Main Results:
- VEGF/VEGFR signaling is a crucial target in mCRC therapy.
- Approved antiangiogenic agents demonstrate significant efficacy in mCRC treatment.
- Regorafenib is an effective antiangiogenic TKI for mCRC.
Conclusions:
- Targeting VEGF/VEGFR signaling is a validated strategy for mCRC.
- Antiangiogenic TKIs, particularly regorafenib, represent important therapeutic options for patients with mCRC.
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