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Challenges of Antiangiogenic Therapy of Tumors

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Angiogenesis

After the approval of the first antiangiogenic agent, bevacizumab, in February 2004, a humanized monoclonal antibody anti-vascular endothelial growth factor (VEGF), this category of new anticancer drugs expanded rapidly. At the end of 2006, the U.S. Food and Drug Administration (FDA) approved bevacizumab for therapy of advanced colorectal and non-small cell lung cancers (except squamous cell histotype), sunitinib for advancedrefractory renal cancer and for imatinib-resistant gastro- intestinal stromal tumors (GISTs), and sorafenib for recurrent advanced kidney cancer. Twelve antiangiogenic drugs entered Phase III trials and at least another 15-20 are under evaluation in Phase I-II studies. Such a rapid clinical development of inhibitors of angiogenesis with different pharmacodynamic and pharmacokinetic characteristics opens a number of challenges, including: the identification of targets of choice; the optimal therapeutic strategy; the rational selection of the patients; proper study-design of clinical trials as well as the monitoring of drug efficacy; management of toxicity; and, finally, the determination of the disease stage to obtain the best benefit. All the above relevant issues are presented and discussed in this chapter.

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Authors and Affiliations

  1. Division of Medical Oncology, Azienda Ospedaliera “San Filippo Neri”, Rome, Italy

    Roberta Sarmiento, Raffaele Longo & Giampietro Gasparini

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  1. Roberta Sarmiento
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  2. Raffaele Longo
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  3. Giampietro Gasparini
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Editors and Affiliations

  1. Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA

    William D. Figg

  2. Department of Surgery Harvard Medical School and Vascular Biology Program, Children's Hospital Boston, Boston, MA, USA

    Judah Folkman

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Sarmiento, R., Longo, R., Gasparini, G. (2008). Challenges of Antiangiogenic Therapy of Tumors. In: Figg, W.D., Folkman, J. (eds) Angiogenesis. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-71518-6_40

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  • DOI: https://doi.org/10.1007/978-0-387-71518-6_40

  • Publisher Name: Springer, Boston, MA

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