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Tumor angiogenesis is critical for the growth of primary cancers above 1-2 mm in diameter. A major vascular growth factor is VEGF, and approaches to inhibit VEGF have shown encouraging results in pre-clinical studies. The mechanisms involved in switching on angiogenesis involve activation of oncogenes and upregulation of the hypoxia-sensing pathway. These provide novel targets for therapy. Many anti-angiogenic drugs are in clinical trial currently and there are problems in assessing these types of drugs if they only cause disease stabilisation. It will be important to develop methods to assess inhibition of vascular growth in vivo. New generations of anti-angiogenesis drugs such as endostatin of angiostatin, which are more potent, may cause tumor regression, but this has not yet been studied in patients. These approaches for advanced disease should be more successful when applied early in an adjuvant situation. This will also require careful monitoring of long-term toxicity.

Original publication

DOI

10.1007/978-3-642-45769-2_33

Type

Journal article

Journal

Recent Results Cancer Res

Publication Date

1998

Volume

152

Pages

341 - 352

Keywords

Breast Neoplasms, Chemotherapy, Adjuvant, Clinical Trials as Topic, Female, Genetic Therapy, Humans, Neoadjuvant Therapy, Neovascularization, Pathologic, Oncogenes, RNA Processing, Post-Transcriptional