Vascular endothelial growth factor (VEGF) as a target of bevacizumab in cancer: from the biology to the clinic.

Abstract

Angiogenesis is important in the growth and progression of solid tumours. The main pro-angiogenic factor, namely vascular endothelial growth factor (VEGF), also known as vascular permeability factor, is a potent angiogenic cytokine that induces mitosis and also regulates the permeability of endothelial cells. The soluble isoform of VEGF is a dimeric glycoprotein of 36-46 kDa, induced by hypoxia and oncogenic mutation and it binds to two specific tyrosine-kinase receptors: VEGF-1 (flt-1) and VEGF-2 (KDR/flk1). An increase in VEGF expression in tumour tissue or some blood compartments (i.e. serum or plasma) has been found in solid and haematological malignancies of various origins and is associated with metastasis formation and poor prognosis. Bevacizumab, a recombinant humanised monoclonal antibody developed against VEGF, binds to soluble VEGF, preventing receptor binding and inhibiting endothelial cell proliferation and vessel formation. Pre-clinical and clinical studies have shown that bevacizumab alone or in combination with a cytotoxic agent decreases tumour growth and increases median survival time and time to tumour progression. Bevacizumab is the first anti-angiogenetic treatment approved by the American Food and Drug Administration in the first-line treatment of metastatic colorectal cancer. It has shown preliminary evidence of efficacy for breast, non-small-cell lung, pancreatic, prostate, head and neck and renal cancer as well as haematological malignancies. Common toxicities associated with bevacizumab include hypertension, proteinuria, bleeding episodes and thrombotic events. This review summarises the critical role of VEGF and discusses the data available on bevacizumab, from the humanisation of its parent murine monoclonal antibody (mAb) A.4.6.1 to its use in cancer clinical trials.

• Authors: Girolamo Ranieri, Rosa Patruno, Eustachio Ruggieri, Severino Montemurro, Paolo Valerio, Domenico Ribatti
• Journal: Current medicinal chemistry (Curr Med Chem) Vol. 13 Issue 16 Pg. 1845-57 ( 2006) ISSN: 0929-8673 [Print] United Arab Emirates
• PMID: 16842197 (Publication Type: Journal Article, Review)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Vascular Endothelial Growth Factors
• Bevacizumab
• Receptors, Vascular Endothelial Growth Factor

Topics

• Amino Acid Sequence
• Angiogenesis Inhibitors (pharmacology, therapeutic use)
• Antibodies, Monoclonal (pharmacology, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents (pharmacology, therapeutic use)
• Bevacizumab
• Clinical Trials as Topic
• Drug Evaluation, Preclinical
• Humans
• Molecular Sequence Data
• Neoplasm Metastasis (drug therapy, pathology)
• Neoplasms (blood supply, drug therapy, pathology)
• Neovascularization, Pathologic (drug therapy, pathology)
• Receptors, Vascular Endothelial Growth Factor (antagonists & inhibitors)
• Vascular Endothelial Growth Factors (antagonists & inhibitors)