कैंसर विज्ञान एवं चिकित्सा

Angio-Inhibitors in Ovarian Cancer

Abstract

Nikos G Gavalas, Sofia-Paraskevi Trachana, Meletios A Dimopoulos and Aristotle Bamias

Ovarian Cancer represents the most fatal type of gynaecological malignancies. The tumor microenvironment consists the region where a number of processes contributing to the pathogenesis of this deadly disease occur. Except the cell proliferation process itself, processes such as angiogenesis can be held accountable for the progress of disease. More specifically, angiogenesis represents a hallmark phenomenon in cancer and a number of studies have shown that it is responsible for the spread of tumor and metastasis in most types of cancer including ovarian cancer. The process leads to new blood vessel formation and stabilization of the tumor vasculature. In recent years angiogenesis has been given considerable attention in order to identify novel targets for developing effective antitumor therapies. Among other families of molecules, growth factors have been identified to play important roles in driving the process of angiogenesis and thus the formation of new blood vessels that play the key role in supplying cancer with appropriate nutrients, hence allowing its spread and metastasis. Such molecules include the vascular endothelial growth factor (VEGF), the platelet derived growth factor (PDGF), the fibroblast growth factor (FGF) and the angiopoietin (Ang)/Tie 2 receptor complex. These proteins are key players in molecular pathways located within the tumor cell and they have been recently under heavy research being in the spotlight of the development of anti angiogenic molecules that may act as stand-alone therapeutics (monotherapy) or in combination with current treatment regimes such as standard chemotherapy. Such molecules include Bevacizumab, Sorafenib, Imatinib mesylate, Sunitinib, Trebananib, Aflibercept, Intedanib, Pazopanib, and Cediranib. There is also a special reference to the possible angio-agenic effect that paclitaxel may confer either in monotherapy or in combination with other agents. The roles of these molecules that have been developed in order to combat angiogenesis are described in this paper.