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  • Review Article
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Angiogenesis as a strategic target for ovarian cancer therapy

Nature Clinical Practice Oncology volume 5, pages 194–204 (2008)Cite this article

Abstract

Angiogenesis is a complex and highly regulated process that is crucial for tumor growth and metastasis. Insights into the molecular mechanisms of tumor angiogenesis have led to the identification of potential angiogenic targets and the development of novel antivascular agents. Many of these agents are being evaluated in clinical trials and have shown promising antitumor activity. This Review highlights the results of the latest clinical studies of antivascular agents in ovarian cancer and discusses the challenges and opportunities for future clinical trials.

Key Points

  • Angiogenesis is a complex and highly regulated process by which tumors develop new vasculature, which is essential for growth of the tumor beyond 1 mm in size

  • Anti-VEGF therapy with bevacizumab seems to be a relevant strategy for the treatment of ovarian cancer, with promising results from phase II trials

  • Potentially unique to ovarian cancer is an alarming rate of gastrointestinal perforation, and patients with impending or symptomatic bowel obstruction are at highest risk

  • Additional antivascular strategies, including multitargeted tyrosine kinase inhibitors, have proven efficacious in both preclinical and clinical phase I–II trials

  • With the growing portfolio of antivascular agents, identification of biomarkers to guide drug choice, dosing, the pharmacologic response, and drug resistance is of paramount importance

  • Careful consideration of statistical methodology and trial design are crucial to drug discovery and development

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Figure 1: Mechanisms of tumor neovascularization.

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Acknowledgements

This research was funded, in part, by the National Cancer Institute grants CA109298 and CA110793, the UTMD Anderson Cancer Center SPORE in Ovarian Cancer (P50 CA083639), the Department of Defense (#W81XWH-04-1-0227), the Gynecologic Cancer Foundation, the Marcus Foundation, a Program Project Development Grant from the Ovarian Cancer Research Fund, Inc, and the NCI T32 Academic Gynecologic Oncologist Training Grant. Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscapeaccredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. WA Spannuth is a Fellow in the Departments of Gynecologic Oncology and Cancer Biology, AK Sood is Professor in the Departments of Gynecologic Oncology and Cancer Biology and Director of Ovarian Cancer Research, and RL Coleman is Professor and Director of Clinical Research in the Department of Gynecologic Oncology, at the University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,

    Whitney A Spannuth, Anil K Sood & Robert L Coleman

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Correspondence to Robert L Coleman.

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Spannuth, W., Sood, A. & Coleman, R. Angiogenesis as a strategic target for ovarian cancer therapy. Nat Rev Clin Oncol 5, 194–204 (2008). https://doi.org/10.1038/ncponc1051

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