For many men,
prostate cancer is an indolent disease that, even without definitive
therapy, may have no impact on their quality of life or overall survival. However for those men who are either diagnosed with or eventually develop metastatic disease,
prostate cancer is a painful and universally fatal disease.
Testosterone-lowering hormonal
therapy may control the disease for some time, but patients eventually develop resistance and progress clinically. At this point, only
docetaxel has been shown to improve survival, so clearly additional therapeutic options are needed. Angiogenesis inhibition is an active area of clinical research in
prostate cancer. Without angiogenesis,
tumors have insufficient nutrients and
oxygen to grow larger than a few millimeters and are potentially less likely to metastasize. In
prostate cancer in particular, angiogenesis plays a significant role in
tumor proliferation, and markers of angiogenesis appear to have prognostic significance. Several different compounds have been developed to inhibit angiogenesis, including
monoclonal antibodies, multitargeted
kinase inhibitors, and fusion
proteins. In addition, more traditional agents may also have an impact on angiogenesis. Trials studying
antiangiogenic agents have been conducted in localized and advanced
prostate cancer. There are several large, ongoing phase III trials in metastatic
castration-resistant
prostate cancer. The findings of these and future studies will ultimately determine the role of
angiogenesis inhibitors in the treatment of
prostate cancer.