Clinical Application of Tumor Vascular Disrupting Therapy: A Systematic Review and Meta-Analysis
Wen Tsang1,2, Lu Gan1,2, Zhikun Zhang1,2,3
1National Center for International Research of Bio-Targeting Theranostics, Guangxi Key Laboratory of Bio-Targeting Theranostics, Guangxi Medical University, Nanning, Guangxi, 530021, People's Republic of China.
Purpose:
The occurrence, progression, invasion and metastasis of tumors depend on a tumor vascular network. Vascular disrupting agents (VDAs) are a new class of drugs targeting the tumor vasculature, by blocking the existing tumor blood vessels. However, there is no clear consensus on the clinical efficacy of tumor vascular disrupting therapy. In this study, we performed the first systematic review and meta-analysis of published clinical trials focused on tumor vascular disrupting therapies.
Materials And Methods:
We searched PubMed, EMBASE, and the Cochrane Library to identify clinical trials that used VDAs to treat tumors. After literature screening and data extraction, according to inclusion and exclusion labels, meta-analysis was performed using RevMan5.3 software.
Results:
In this meta-analysis, we included 2659 patients from eight randomized controlled trials involving non-small-cell lung cancer, prostate, epithelial ovarian, fallopian tube, and primary peritoneal carcinoma. Compared with the control arm, the experimental arm exhibited an effective improvement of 0.5-year and 1-year survival, as well as the 6-month progression-free survival rate. There was no significant difference between patients in the experimental compared to the control arm with respect to objective response and disease control rates, and 12-month progression-free survival.
Conclusion:
Vascular disrupting therapy can effectively prolong the survival of cancer patients. However, for indicators of short-term efficacy, such as objective response rate and disease control rate, there is still a lack of high-quality, large-scale clinical trial data to confirm the effectiveness of VDAs.
Insights
Vascular disrupting agents (VDAs) show promise in prolonging cancer patient survival by targeting tumor vasculature. However, more large-scale trials are needed to confirm their short-term efficacy and impact on response rates.
Area of Science:
- Oncology
- Vascular Biology
- Clinical Trials
Background:
- Tumor growth, invasion, and metastasis rely on tumor vascular networks.
- Vascular disrupting agents (VDAs) target and block tumor blood vessels.
- Clinical efficacy of vascular disrupting therapy remains debated.
Purpose of the Study:
- To conduct the first systematic review and meta-analysis of clinical trials on tumor vascular disrupting therapies.
- To evaluate the clinical efficacy of VDAs in cancer treatment.
- To synthesize evidence regarding survival outcomes and response rates.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Cochrane Library.
- Inclusion and exclusion criteria applied to identify relevant clinical trials.
- Meta-analysis performed using RevMan5.3 software on data from eligible trials.
Main Results:
- Included 2659 patients from eight randomized controlled trials (non-small-cell lung cancer, prostate, ovarian, fallopian tube, peritoneal carcinoma).
- Vascular disrupting therapy demonstrated improved 0.5-year and 1-year survival, and 6-month progression-free survival.
- No significant differences observed in objective response, disease control rates, or 12-month progression-free survival.
Conclusions:
- Vascular disrupting therapy effectively prolongs overall survival in cancer patients.
- High-quality, large-scale clinical trial data is lacking to confirm VDA effectiveness for short-term efficacy indicators.
- Further research is warranted to solidify the role of VDAs in cancer treatment regimens.
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