Angiogenesis in Breast Cancer: Molecular Markers, Therapeutic Targets, Antiangiogenic Therapy & Inhibitors
Pp. 68-89 (22)
Carmen Silvia Passos Lima, Gustavo Jacob Lourenco and Jose Augusto Rinck Jr.
Mechanism of angiogenesis and its management in breast cancer disease has been discussed in this chapter. This review specifically describes on the targetted molecular markers for development of antiangiogenic therapy like anti VEGF therapy and suitable agents that target the receptors of VEGF like VEGFR. These are essentially tyrosine kinase inhibitors which block downstream signaling pathways instead of binding to VEGF directly. Block of VEGF production in clinical development that target the EGFR include agents like cetuximab, gefitinib and erlotinib. Other drugs which may be of interest including cyclooxygenase 2 inhibitors and MMP inhibitors find clinical application as angiogenic inhibitors. Tumor associates macrophage which acts as conductor of angiogenesis and notch signaling getting involved in cell proliferation, differentiation and apoptosis are also a target of therapy. Combination of antiangiogenic drugs with one another and with other biological agent is also being explored to improve efficacy and to overcome the drug resistance.
Breast Cancer, Angiogenesis management, Molecular Marker, Notch Signaling
Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil.