Vascular normalization: a real benefit?

It is well established that antibodies to vascular endothelial growth factor (VEGF) in combination with chemotherapeutic agents produce synergistic cytotoxicity in a range of cancer. In this review article, it has been analyzed whether the so-called vascular normalization of abnormal tumor blood vessels as an effect of VEGF inhibition in association with chemotherapeutic agents in the treatment of tumors produces a real benefit. Literature data show that the process of normalization of the structure of tumor blood vessels is not always accompanied with a real benefit. In fact as in the case of cerebral tumors, the process of normalization may induce a re-establishment of the low permeability characteristics of normal brain microvasculature, preventing the delivery of chemotherapeutics.