Abstract
Demonstration of the clinically significant activity of bevacizumab in breast cancer has attracted a great deal of interest. Numerous other antiangiogenic treatments are in clinical development and some established therapies including tamoxifen and trastuzumab might function, in part, by suppressing angiogenesis. In this Review, we discuss the potential of various components of the angiogenic pathway as prognostic and predictive factors in breast cancer. In addition, we describe existing clinical trials of antiangiogenic agents and the challenges facing the clinical development and optimum use of these agents for the treatment of breast cancer.
Key Points
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Angiogenesis and VEGF have important roles in the pathogenesis of breast cancer
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VEGF is regulated by complex factors including hypoxia, growth factors, hormones and activated oncogenes
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Angiogenic markers, such as VEGF, can be of prognostic and predictive value in breast cancer
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Clinical trials of antiangiogenic agents such as bevacizumab and tyrosine kinase inhibitors in breast cancer are ongoing
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Bevacizumab in combination with paclitaxel can improve progression-free survival in patients with previously untreated metastatic breast cancer
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Challenges facing the success of antiangiogenic therapy in breast cancer include the identification of biomarkers to guide management, overcoming drug resistance and identifying the correct target population
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Acknowledgements
We thank Avon Breast Cancer Crusade, Breakthrough Breast Cancer, The Mary Jean Mitchell-Greene Foundation and Cancer Research UK for funding.
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S Banerjee declared she has received a research grant from Novartis. L Martin has declared she has received a research grant from AstraZeneca and Novartis. M Dowsett declared he has been a Consultant for Novartis and Roche, he has been on speakers bureau for Novartis and Roche, and has received a research grant from Novartis. A Ashworth has declared he has no competing interests.
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Banerjee, S., Dowsett, M., Ashworth, A. et al. Mechanisms of Disease: angiogenesis and the management of breast cancer. Nat Rev Clin Oncol 4, 536–550 (2007). https://doi.org/10.1038/ncponc0905
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DOI: https://doi.org/10.1038/ncponc0905
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