Summary: Blood vessel formation in tumor is defined as tumor angiogenesis. So far, the most known its mechanism is sprouting, which means formation of blood vessels from existing ones, as a result of the proliferation and migration of endothelial cells. The main mitogenic factor of these cells is vascular endothelial growth factor VEGF, acting by VEGFR-2 receptors. Recent studies have provided knowledge about the ability of tumors to form vessel-like structures. The phenomenon was called vascular mimicry. Tumor cells show a high plasticity and they can undergo differentiation to the ones with phenotype similar to endothelial cells. Each of the known tumor angiogenesis mechanisms is a result of many different factors and cell cooperation in tumor microenvironment. Tumor ability to the heterogeneous vascularization forces developing of complex, anti-angiogenic therapy directed to different molecular and cellular targets. Therapies, used so far, often lead to drug-induced hypoxia, which increases tumor cell aggressiveness and metastasis.Keywords: tumor angiogenesis, vasculogenic mimicry, anti-angiogenic strategies, resistance to anti-angiogenic therapy Sprouting angiogenesis -formation via endothelial cells proliferation and migration towards avascular tumor area of new branches of blood vessels Intussusception -formation of blood vessels as a result of intussusception (septum) inside existing blood vessels Co-option -oxygen and nutrients acquire as a result of tumor cells migration along existing blood vessels Vasculogenic mimicry -formation by tumor cells of vessel-like structures, without endothelial cells participation Vasculogenesis -formation of tumor blood vessels de novo, as a result of endothelial progenitor cells recruitment
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