Based on preclinical data, it has been suggested that antiangiogenic compounds could improve cytotoxic drug delivery because of their effects on tumor endothelium. Most of the early clinical testing of these agents was conducted in patients with advanced disease resistant to standard therapies, and while some of the phase III trial data were disappointing, recent studies validated in large clinical trials with the anti-VEGF antibody, bevacizumab, demonstrated significant clinical benefit and renewed enthusiasm for this therapeutic strategy. This review highlights the challenges related to choosing appropriate strategies for the selection of patients, study design, and choice of appropriate endpoints for the study development of these agents.
- Giampietro Gasparini
- Raffaele Longo
- Napoleone Ferrara