Antiangiogenic therapy for breast cancer.

Dorte Lisbet Nielsen,Michael Andersson,Claus Kamby,Jon Lykkegaard Andersen

doi:10.1186/bcr2642

Dorte Lisbet Nielsen, Michael Andersson + Show 2 more

Open Access

https://doi.org/10.1186/bcr2642

Copy DOI

Abstract

Angiogenesis is an important component of cancer growth, invasion and metastasis. Therefore, inhibition of angiogenesis is an attractive strategy for treatment of cancer. We describe existing clinical trials of antiangiogenic agents and the challenges facing the clinical development and optimal use of these agents for the treatment of breast cancer. Currently, the most promising approach has been the use of bevacizumab, a humanized monoclonal antibody directed against the most potent pro-angiogenic factor, vascular endothelial growth factor (VEGF). Small molecular inhibitors of VEGF tyrosine kinase activity, such as sorafenib, appear promising. While, the role of sunitinib and inhibitors of mammalian target of rapamycin (mTOR) in breast cancer has to be defined. Several unanswered questions remain, such as choice of drug(s), optimal duration of therapy and patient selection criteria.

Highlights

Angiogenesis is a pivotal component of cancer growth, including invasion and metastasis
This review focusses on clinical aspects of treatment of breast cancer with monoclonal antibodies, and tyrosine kinase and mammalian target of rapamycin inhibitors
Data on treatment administered after progression were not collected in this trial, precluding an exploratory analysis of the influence of subsequent therapy on OS

Summary

Introduction

Angiogenesis is a pivotal component of cancer growth, including invasion and metastasis. Tumours induce blood vessel growth (angiogenesis) by secreting various growth factors (for example, vascular endothelial growth factor (VEGF)). Growth factors, such as basic fibroblast growth factor and VEGF, can induce capillary growth into the tumour, which allows tumour expansion. Angiogenesis is a necessary and required step for transition from a small harmless cluster of cells to a large tumour and is required for the spread of a tumour, invasion and/or metastasis. Several antiangiogenic therapies are in clinical trials testing their promise in breast cancer. This review focusses on clinical aspects of treatment of breast cancer with monoclonal antibodies, and tyrosine kinase and mammalian target of rapamycin (mTOR) inhibitors. New pivotal angiogenic pathways, such as the Notch ligand Delta-like 4 pathway, are briefly reviewed

Methods

Results

Discussion

Conclusion