Dipartimento di Anatomia Umana e Istologia, Università degli Studi di Bari, Italy.
Cancer Treat Rev. 2011 Aug;37(5):344-52. doi: 10.1016/j.ctrv.2011.02.002. Epub 2011 Mar 23.
Angiogenesis, the formation of new blood vessels from established vasculature, is a fundamental process in the growth and metastasis of solid tumours. It is a complex, tightly regulated process that requires the coordinated action of antiangiogenic and proangiogenic factors, the balance of which becomes disturbed during tumour development. Vascular endothelial growth factor (VEGF) and its receptor are the key mediators of angiogenesis and targets for multiple pharmacologic agents. Many patients treated with VEGF inhibitors survive for a longer period; however, eventual resistance is associated with progressive disease and death. Multiple approaches to overcome resistance have been investigated with varying success, including the use of agents that target multiple angiogenic factors or co-administration of angiogenesis inhibitors with standard chemotherapy or radiotherapy. It would appear that the future of angiogenic inhibitors lies in the intelligent combination of multiple targeted agents with other angiogenic inhibitors, as well as more conventional therapies to maximise therapeutic effect.
血管生成，即从已有的脉管系统中形成新的血管，是实体瘤生长和转移的基本过程。这是一个复杂的、受到严格调控的过程，需要抗血管生成和促血管生成因子的协调作用，而在肿瘤发展过程中这种平衡会被打破。血管内皮生长因子（VEGF）及其受体是血管生成的关键介质，也是多种药物的作用靶点。许多接受 VEGF 抑制剂治疗的患者存活时间更长；然而，最终的耐药性与疾病的进展和死亡有关。为了克服耐药性，人们已经研究了多种方法，但取得的成功程度不一，包括使用针对多种血管生成因子的药物，或者将血管生成抑制剂与标准化疗或放疗联合使用。看起来，抗血管生成抑制剂的未来在于将多种靶向药物与其他血管生成抑制剂以及更传统的疗法相结合，以最大限度地发挥治疗效果。
