Title:Antiangiogenic Drugs in the Treatment of Advanced Epithelial Ovarian Cancer
Volume: 12
Issue: 8
Author(s): Parham Khosravi-Shahi and Luis Cabezon-Gutierrez
Affiliation:
Keywords:
Bevacizumab, BIBF-1120, VEGF, Angiogenesis, Pazopanib, morphologic, endometrioid, carcinomas, morphologic continuum, tumor progression
Abstract: Epithelial ovarian cancer (EOC) accounts for approximately 80-90% of all ovarian cancers, and 75% of the patients
are diagnosed with advanced disease (stage III and IV). Front-line systemic chemotherapy improves survival in women with advanced
EOC; however, tumor recurrence occurs in almost all advanced EOC patients at a median of 15 months from diagnosis, and 5-year
survival is estimated at 10 to 30%. Additionally, around 20% of patients do not respond to standard front-line therapy. Tumoral
angiogenesis plays an important role in the pathogenesis of EOC, and its inhibition might improve survival in patients with advanced
EOC. High-grade EOC is characterized by overexpression of vascular endothelial growth factor (VEGF), which drives dysfunctional
tumor-associated angiogenesis, contributing to high interstitial pressure and increased vascular permeability. Diverse anti-angiogenic
drugs are under investigation, and direct targeting of this pathway can be achieved by sequestration of VEGF protein using monoclonal
antibodies (bevacizumab) or engineered binding site molecules (aflibercept), blockade of the VEGF receptor-2 with monoclonal
antibodies or inhibition of receptor associated tyrosine kinase with low molecular weight inhibitors (cediranib, pazopanib, sorafenib or
BIBF-1120).
