Gasparini G, Harris A L
Department of Oncology, St. Bortolo Regional Medical Center, Vicenza, Italy.
J Clin Oncol. 1995 Mar;13(3):765-82. doi: 10.1200/JCO.1995.13.3.765.
To review prognostic and therapeutic applications of angiogenesis research in breast carcinoma.
We reviewed the (1) biologic role of angiogenesis, particularly in transformation, progression, and metastasis of breast cancer; (2) methods to detect angiogenic activity in human pathology; (3) clinical studies relating clinical outcome of patients with breast cancer to the assessment of angiogenesis; (4) predictive value of angiogenesis for response to anticancer therapies; and (5) pharmacologic characteristics of current antiangiogenic drugs.
There is mounting evidence that angiogenesis plays a relevant role in the biologic aggressiveness of breast cancer. Using either immunohistochemical or biochemical methods, several studies have shown a worse prognosis for those patients with tumors with high angiogenic activity. In some studies angiogenesis has an independent prognostic value. The most promising angiogenic inhibitors are under early-phase clinical evaluation in patients with tumors resistant to conventional therapies. Novel therapeutic strategies for breast cancer patients are presented and discussed.
The majority of the retrospective studies show that angiogenesis is an important new prognostic indicator in early-stage breast carcinoma. This marker should be evaluated in prospective controlled clinical trials to demonstrate whether adjuvant therapies may improve the prognosis of those patients at high risk, eg, those with highly vascularized tumors. Since invasive breast carcinoma has a well defined stromal vascular component and produces angiogenic factors, it seems reasonable to postulate that this tumor may be one of the most responsive to angiogenesis inhibitors given alone or in combination with conventional anticancer treatments.
综述血管生成研究在乳腺癌中的预后及治疗应用。
我们回顾了以下内容：（1）血管生成的生物学作用，尤其是在乳腺癌的转化、进展和转移中的作用；（2）在人体病理学中检测血管生成活性的方法；（3）将乳腺癌患者的临床结局与血管生成评估相关联的临床研究；（4）血管生成对抗癌治疗反应的预测价值；（5）当前抗血管生成药物的药理学特性。
越来越多的证据表明血管生成在乳腺癌的生物学侵袭性中起相关作用。多项研究通过免疫组织化学或生物化学方法表明，血管生成活性高的肿瘤患者预后较差。在一些研究中，血管生成具有独立的预后价值。最有前景的血管生成抑制剂正在对常规治疗耐药的肿瘤患者中进行早期临床评估。本文提出并讨论了针对乳腺癌患者的新治疗策略。
大多数回顾性研究表明，血管生成是早期乳腺癌中一个重要的新预后指标。应在前瞻性对照临床试验中评估该标志物，以证明辅助治疗是否可改善高危患者（如肿瘤血管高度丰富的患者）的预后。由于浸润性乳腺癌具有明确的基质血管成分并产生血管生成因子，因此推测该肿瘤可能是对单独使用血管生成抑制剂或与传统抗癌治疗联合使用最敏感的肿瘤之一。
