大肠癌靶向血管生成途径：复杂性、挑战与未来方向

Title:Targeting Angiogenic Pathways in Colorectal Cancer: Complexities, Challenges and Future Directions

Volume: 18 Issue: 1

Author(s): Khurum Khan, David Cunningham, Ian Chau

Affiliation:

关键词: 结直肠癌，血管再生术，血管增生抑制剂，生物标记物，血管内皮生长因子（VEGF），bevacizumab

摘要: Colorectal cancer (CRC) is one of the commonest cancers in the world. During the last decade, the development of targeted therapies has given cancer treatment a novel direction in management of metastatic CRC (mCRC) and has enriched the therapeutic armamentarium in the management of this disease. In mCRC, targeting angiogenesis via the vascular endothelial growth factor (VEGF) pathway has been of particular interest based on the favourable survival benefit demonstrated by bevacizumab in clinical trials. More recently, large phase III studies have shown clinical efficacy for the new antiangiogenic agents aflibercept and regorafenib. However, the results of pre-clinical and clinical studies of other anti-angiogenic agents have been disappointing.

Furthermore, the benefits from angiogenic inhibitors (AIs) in an unselected patient population are modest. Research into predictive biomarkers is therefore essential, but has, to date, been unsuccessful. Nevertheless, aflibercept and regorafenib have been shown to benefit both bevacizumab naive and refractory patients, suggesting that acquired resistance to AIs can be potentially reversed. This review describes the most recent advances in development of AIs in mCRC with particular focus on aflibercept and regorafenib, the existing challenges for the evaluation of these agents in clinical practice and potential strategies in designing clinical trials that could lead to the discovery of clinically meaningful biomarkers.

Cite this article as:

Khurum Khan, David Cunningham, Ian Chau , Targeting Angiogenic Pathways in Colorectal Cancer: Complexities, Challenges and Future Directions, Current Drug Targets 2017; 18 (1) . https://dx.doi.org/10.2174/1389450116666150325231555

DOI https://dx.doi.org/10.2174/1389450116666150325231555	Print ISSN 1389-4501
Publisher Name Bentham Science Publisher	Online ISSN 1873-5592