Related Experiment Video
Updated: Aug 31, 2025
Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition
Published on: March 11, 2021
Radiation therapy and antiangiogenic therapy: Opportunities and challenges
1Département de radiothérapie, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
Abstract:
The importance of tumoral vascularization as a therapeutic target was first described in 1971 by Folkman. Anarchic vascularization in response to tumour hypoxia, especially mediated by vascular endothelial growth factor, represents a major target in the management of many cancers. The contribution of systemic anti-angiogenic treatments including humanized anti-VEGF monoclonal antibodies (bevacizumab) and tyrosine kinase inhibitors, whose effect on vascular normalization and correction of tumour hypoxia has been shown in preclinical studies to be enhancing the effect of radiotherapy. Early trials combining radiotherapy and antiangiogenics with a small number of patients have contradictory results and tend to put into perspective the opportunity that this synergistic association represents. The efficiency found must be tempered by some toxicity described, especially in association with high doses per fraction. The aim of this article is to present the main studies reporting the efficiency and safety of the combination of antiangiogenic drugs and radiotherapy, as well as the expected opportunities.
Insights
Combining anti-angiogenic drugs with radiotherapy shows mixed results for cancer treatment. While potentially synergistic, careful consideration of toxicity, especially with high radiation doses, is crucial for optimizing patient outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Cancer Biology
Background:
- Tumoral vascularization, crucial for cancer growth, is a key therapeutic target.
- Vascular endothelial growth factor (VEGF) drives abnormal tumor vascularization and hypoxia.
- Anti-angiogenic therapies aim to normalize tumor vasculature and reduce hypoxia.
Purpose of the Study:
- To review the efficacy and safety of combining anti-angiogenic drugs with radiotherapy.
- To discuss the potential benefits and challenges of this combined treatment approach.
Main Methods:
- Systematic review of preclinical and clinical studies.
- Analysis of data from early-phase clinical trials combining radiotherapy with anti-angiogenics (e.g., bevacizumab).
Main Results:
- Preclinical studies suggest anti-angiogenics enhance radiotherapy by normalizing tumor vasculature and improving oxygenation.
- Early clinical trials report contradictory results regarding efficacy.
- Increased toxicity, particularly with high radiation doses per fraction, has been observed.
Conclusions:
- The combination of anti-angiogenic drugs and radiotherapy presents a complex therapeutic strategy.
- Further research is needed to optimize treatment protocols and mitigate toxicity for improved cancer patient outcomes.
Related Concept Videos
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:27Tumor Immunotherapy
01:24Regulation of Angiogenesis and Blood Supply
02:56Treatment Resistant Cancers
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...