Abstract

Solid tumors carry out the formation of new vessels providing blood supply for growth, tumor maintenance, and metastasis. Several processes take place during tumor vascularization. In angiogenesis, new vessels are derived from endothelial cells of pre-existing vessels; while in vasculogenesis, new vessels are formed de novo from endothelial progenitor cells, creating an abnormal, immature, and disorganized vascular network. Moreover, highly aggressive tumor cells form structures similar to vessels, providing a pathway for perfusion; this process is named vasculogenic mimicry (VM), where vessel-like channels mimic the function of vessels and transport plasma and blood cells. VM is developed by numerous types of aggressive tumors, including ovarian carcinoma which is the second most common cause of death among gynecological cancers. VM has been associated with poor patient outcome and survival in ovarian cancer, although the involved mechanisms are still under investigation. Several signaling molecules have an important role in VM in ovarian cancer, by regulating the expression of genes related to vascular, embryogenic, and hypoxic signaling pathways. In this review, we provide an overview of the current knowledge of the signaling molecules involved in the promotion and regulation of VM in ovarian cancer. The clinical implications and the potential benefit of identification and targeting of VM related molecules for ovarian cancer treatment are also discussed.

Highlights

  • Ovarian cancer is the second most common and lethal gynecological cancer [1]

  • We provide an overview of the current knowledge of the mechanisms and signaling molecules involved in the promotion and regulation of vasculogenic mimicry (VM) in ovarian cancer, its clinical implications and the potential benefit of therapeutic approaches based on the identification and targeting of VM related molecules

  • The precise mechanism has not been clearly described, it is known that MMP-2 cleavages Ln5γ2 into two pro-metastatic fragments (Ln5γ2′ and Ln5γ2x) [53]. These results indicate that the Vascular endothelial (VE)-cadherin/Ephrin-A2 receptor (EphA2)/MMP-2/Ln5γ2 axis is the main regulator of VM

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Summary

Introduction

Ovarian cancer is the second most common and lethal gynecological cancer [1]. Among ovarian cancer types, the epithelial ovarian cancer accounts for almost 90% of such malignancy [2], which is usually diagnosed in advanced aggressive stages due to its asymptomatic nature. Vasculogenic mimicry (VM), has been shown to increase after anti-angiogenic treatment with bevacizumab, in preclinical models of ovarian cancer [9]. It was demonstrated that in SKOV-3 and OVCAR-3 ovarian cancer cells, the ablation of uPA expression results in a decrement of complete VM structures formation and such mechanism involves the participation of AKT/mTOR/MMP-2/Laminin5γ2 signal pathways [54].

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