No abstract

Significance Withdrawal of antiangiogenic drugs leads to tumor revascularization, even rebound effects of tumor angiogenesis, and potential metastasis. Long-term maintenance therapy with antiangiogenic drugs is crucial for achieving maximal clinical benefits for cancer patients. There are no antiangiogenic drugs that are clinically available for maintenance therapy. We show that orally active capecitabine at an extremely low and nontoxic dose displays a potent antiangiogenic effect that can be used for maintenance therapy. Importantly, the low-dose capecitabine in a sequentially therapeutic setting following anti-VEGF drugs produces remarkable anticancer effects. If successfully proven in clinical settings, our therapeutic regimen would be beneficial for millions of cancer patients. Our findings will shift the paradigm of current antiangiogenic therapy for treatment of human cancer patients.