Combining Angiogenesis Inhibitors with Radiation: Advances and Challenges in Cancer Treatment

Abstract

Background: Radiation therapy is a widely employed modality which is used to destroy cancer cells, but it also tends to induce changes in the tumor microenvironment and promote angiogenesis. Radiation when used as a sole means of therapeutic approach to treat cancer, tends to trigger the angiogenic pathways, leading to the upregulation of several angiogenic growth factors such as VEGF, bFGF, PDGF and angiogenin. This uncontrolled angiogenesis leads to certain angiogenic disorders like vascular outgrowth and increase in the tumor progression that can pose a serious threat to patients. Objective: This review emphasizes on various components of the tumor microenvironment, angiogenic growth factors and biological effects of radiation on tumors in provoking the relapse. It also describes the angiogenic mechanisms that trigger the tumor relapse after radiation therapy and how angiogenesis inhibitors can help in overcoming this phenomenon. It gives an overview of various angiogenesis inhibitors in pre-clinical as well as in clinical trials. Conclusion: The review focuses on the beneficial effects of combinatorial therapeutic approach of anti-angiogenesis therapy and radiation in tumor management.

Delivery of miR‐3529‐3p using MnO2‐SiO2‐APTES nanoparticles combined with phototherapy suppresses lung adenocarcinoma progression by targeting HIGD1A

“…These factors are associated with degradation of the extracellular matrix and the advancement of tumor metastasis and angiogenesis 42 . In vascular endothelial cells, miR‐3529‐3p downregulated the expression of VEGF and bFGF, which not only stimulate vascular permeability, but also trigger the migration of endothelial cells 43 . Considering the antiangiogenic role of miR‐3529‐3p in cells, we also assessed neovascularization in a xenograft model.…”

Anti-angiogenic therapy for advanced primary pulmonary lymphoepithelioma-like carcinoma: a retrospective multicenter study

“…Combination of anti-angiogenic therapy with other therapies, including chemotherapy, radiotherapy, immunotherapy and anti-EGFR therapy, has good efficacy due to the vaso-normalization effect induced by anti-angiogenic agents (Tian et al 2020 ). Radiation alone as the sole means of treating cancer often triggers the angiogenesis pathway, leading to upregulation of multiple angiogenic growth factors, and anti-angiogenic inhibitors can help overcome this fact (Rani and Prabhu 2021 ). Randomized Phase III studies have also shown that treatment with antiangiogenic agents in combination with programmed cell death ligand 1 (PD-L1) antibodies significantly improves survival compared with standard therapy in renal cell carcinoma (RCC), NSCLC and hepatocellular carcinoma (HCC) (Hack et al 2020 ).…”

Anti-angiogenic Therapy for Advanced Primary Pulmonary Lymphoepithelioma-like Carcinoma: a Retrospective Multicenter Study

“…Combination of anti-angiogenic therapy with other therapies, including chemotherapy, radiotherapy, immunotherapy and anti-epidermal growth factor receptor (EGFR) therapy, has good e cacy due to the vasonormalization effect induced by anti-angiogenic agents 31 . Radiation alone as the sole means of treating cancer often triggers the angiogenesis pathway, leading to upregulation of multiple angiogenic growth factors, and anti-angiogenic inhibitors can help overcome this fact 32 . Randomized Phase III studies have also shown that treatment with antiangiogenic agents in combination with PD-L1 antibodies signi cantly improves survival compared with standard therapy in RCC, NSCLC and HCC.…”