New ways to successfully target tumor vasculature in ovarian cancer

Abstract

Purpose of review The aim of this paper was to review the recent literature on potential therapeutic strategies for overcoming resistance to anti-VEGF drugs in ovarian cancer. Recent findings Although clinical benefits of anti-VEGF therapy were observed in ovarian cancer treatment trials, this use yielded only modest improvement in progression-free survival, and with the exception of cediranib no effect on overall survival. Adaptive resistance and escape from anti-angiogenesis therapy is likely a multifactorial process, including induction of hypoxia, vascular modulators and the immune response. New drugs targeting the tumor vasculature or other components of the surrounding microenvironment have shown promising results. Summary When to start and end antiangiogenesis therapy and the choice of optimal treatment combinations remain controversial. Further evaluation of personalized novel angiogenesis-based therapy is warranted. Defining the critical interaction of these agents and pathways and the appropriate predictive markers will become an increasingly important objective for effective treatment.

Ovarian cancer

“…Within the many components of the tumor microenvironment, angiogenesis has a critical role in the pathogenesis of epithelial ovarian cancer, promoting tumour growth and metastasis (112).…”

State of the science: Emerging therapeutic strategies for targeting angiogenesis in ovarian cancer

“…Silencing of Dll4 in ovarian tumor cells and tumor-associated endothelial cells inhibited tumor growth and angiogenesis [17]. Therapeutic agents targeting the Dll4/Notch pathway, such as γ-secretase inhibitors and anti-Dll4 antibodies (demcizumab and REGN421) are currently being investigated [20]. Numerous studies have highlighted the association between inflammation and tumor progression [21,22].…”

The path to personalized medicine in women's cancers

“…Yang et al [7] describe new approaches to overcome adaptive resistance for drugs targeting tumor vasculature. For example, clinical benefits of antivascular endothelial growth factor therapy have been observed in ovarian cancer treatment trials; however, this use yielded only modest improvement in progression-free survival and development of resistance to antivascular endothelial growth factor therapy over time is inevitable.…”