Purpose: Angiogenesis and vessel hyperpermeability are the two factors leading to the formation of ascites. Vascular endothelial growth factor (VEGF) plays a pivotal role in malignant ascites formation.We have recently shown that albendazole inhibits peritoneal growth of human colorectal cancer cells . The present study was designed to find out if albendazole can suppress ascites formation in ascites-producing peritoneal carcinomatosis. Experimental design: Female nude mice bearing peritoneal tumors of human ovarian cancer cells (OVCAR-3) were treated with albendazole. Following i.p. inoculation and ascites development, mice were given i.p. albendazole (150 mg/kg) or the vehicle  3 weekly for 4 weeks. Results: Whereas vehicle-treated mice developed overt ascites requiring repeated aspiration, ascites formation in the albendazole-treated mice was markedly suppressed. As a result of this, 7 of 10 mice from the control group had to be euthanized before the course of treatment was over. Suppressed ascites production and reduced tumor vascularity observed was a result of dramatic reduction in tumor VEGF production as revealed by profoundly lower VEGF ascites fluid and plasma levels. In vitro, incubation of SKOV-3 cells with various concentrations of albendazole led to significant dose-dependent inhibition of VEGF secretion. Examination of floating tumor cells collected from the peritoneal wash revealed profound down-regulation of VEGF mRNA in albendazole-treated mice. Conclusions: These findings suggest for the first time that in nude mice bearing OVCAR-3 peritoneal tumors, by inhibiting VEGF production, albendazole abolishes tumor angiogenesis and ascites formation.The formation of malignant ascites in patients with advancedstage cancer is a difficult problem to manage in clinical oncology (1). It is an important cause of morbidity and mortality in patients with peritoneal carcinomatosis arising from colorectal, gastric, pancreatic, endometrial, and ovarian cancers (2). Ovarian carcinoma is characterized by rapid growth of solid i.p. tumors and production of large volumes of ascites. Although malignant progression of this disease is often predominantly confined to the peritoneal cavity (3), two thirds of patients already have advanced disease when diagnosed, and rapidly accumulating ascitic fluid is associated with poor prognosis (4). Both tumor size and the accumulation of ascites are inversely associated with survival (5). Among women with stage III or IV epithelial ovarian carcinoma, development of ascites correlates with a significantly decreased 5-year survival rate (5% with ascites versus 45% without ascites; ref. 6). Despite advances in surgical cytoreduction and cytotoxic chemotherapy, the prognosis for patients with ovarian cancer remains poor (7). Current therapeutic treatment of patients with advanced ovarian cancer associates cytoreductive surgery and chemotherapy, the combination of paclitaxel and a platinum salt being considered as the standard chemotherapy for advanced ovarian cancer (8).Dur...