Bachelot Thomas, Ray-Coquard Isabelle, Cassier Philippe, Blay Jean-Yves
Centre Léon Bérard, Département de Médecine, 28, rue Laennec, 69373 Lyon Cedex 08.
Bull Cancer. 2007 Jul;94 Spec No:S203-10.
The growth of breast cancers, as is the case in other solid tumors, is dependent on the development of neo-vessels. This has been clearly demonstrated in preclinical models and clinical-biological studies. Yet, the biological mechanisms involved in angiogenesis are heterogeneous; pathways activated by vascular endothelial growth factor (VEGF) seem to play a prominent role in the early stages of the disease, whereas a number of other pathways are involved in the development of progressive and metastatic tumors. This might account for the disappointing results of phase III studies of bevacizumab in breast cancer as compared with results reported in renal or colon cancers. The use of new drugs targeting other angiogenic factors and a better selection of patients eligible for treatment might improve these results. This is a review of the major biological and clinical data available on the critical role of angiogenesis in breast cancer. We will also review the different clinical studies reported to date in this area.
与其他实体瘤一样,乳腺癌的生长依赖于新生血管的形成。这在临床前模型和临床生物学研究中已得到明确证实。然而,血管生成所涉及的生物学机制是异质性的;血管内皮生长因子(VEGF)激活的通路似乎在疾病早期发挥着重要作用,而其他一些通路则参与进展期和转移性肿瘤的发展。这可能解释了与肾癌或结肠癌报道的结果相比,贝伐单抗在乳腺癌III期研究中令人失望的结果。使用针对其他血管生成因子的新药以及更好地选择适合治疗的患者可能会改善这些结果。本文综述了关于血管生成在乳腺癌中的关键作用的主要生物学和临床数据。我们还将回顾该领域迄今为止报道的不同临床研究。