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Nature Reviews Cancer 7, 327-331 (May 2007) | doi:10.1038/nrc2130

The Delta paradox: DLL4 blockade leads to more tumour vessels but less tumour growth

Gavin Thurston1, Irene Noguera-Troise1 & George D. Yancopoulos1  About the authors

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Anti-angiogenesis therapies have emerged as important treatment options for several types of tumours. To date, these therapies have focused on blocking the vascular endothelial growth factor (VEGF) pathway. A recent series of papers have shown that one ligand for the Notch receptors, Delta-like ligand 4 (DLL4), is normally induced by VEGF and is a negative-feedback regulator that restrains vascular sprouting and branching. Consistent with this role, the deletion or inhibition of DLL4 results in excessive, non-productive angiogenesis. This unrestrained angiogenesis unexpectedly and paradoxically decreases tumour growth, even in tumours resistant to anti-VEGF therapies. Can too much angiogenesis be bad for tumours but good for patients?

Author affiliations

  1. Gavin Thurston, Irene Noguera-Troise and George D. Yancopoulos are at Regeneron Pharmaceuticals, 777 Old Saw Mill River Road, Tarrytown, New York 10591, USA.

Correspondence to: Gavin Thurston1 Email: Gavin.Thurston@regeneron.com

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