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Modes of resistance to anti-angiogenic therapy
Open accessAbstract
Angiogenesis inhibitors targeting the vascular endothelial growth factor (VEGF) signalling pathways are affording demonstrable therapeutic efficacy in mouse models of cancer and in an increasing number of human cancers. However, in both preclinical and clinical settings, the benefits are at best transitory and are followed by a restoration of tumour growth and progression. Emerging data support a proposition that two modes of unconventional resistance underlie such results: evasive resistance, an adaptation to circumvent the specific angiogenic blockade; and intrinsic or pre-existing indifference. Multiple mechanisms can be invoked in different tumour contexts to manifest both evasive and intrinsic resistance, motivating assessment of their prevalence and importance and in turn the design of pharmacological strategies that confer enduring anti-angiogenic therapies.
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“Drug resistance in cancer can be cell-intrinsic (Poulikakos and Rosen, 2011) or a combination of host and tumor mediated pathways (Bergers and Hanahan, 2008; Ebos et al., 2009).”
From A CXCL1 Paracrine Network Links Cancer Chemoresistance and Metastasis (2012) · cites this paper as Bergers and Hanahan, 2008
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“Several cellular and molecular mechanisms of escape from antiangiogenic therapies have been postulated and investigated, including activation of alternative angiogenic pathways, recruitment of proangiogenic myeloid cells, increased pericyte cell coverage of tumour blood vessels, increased tumour cell invasion, and alternative modes of vessel recruitment7,9,80”
From Enhancing cancer immunotherapy using antiangiogenics: opportunities and challenges (2018) · cites this paper as [80]
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“This dual blockade approach can provide tumour control in some preclinical models, although the degree of benefit and the underlying mechanism of action seem to be context-dependent31,32,80,89.”
From Enhancing cancer immunotherapy using antiangiogenics: opportunities and challenges (2018) · cites this paper as [80]
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“Consequently, PDAC is difficult to treat with anti-angiogenics; therefore, novel approaches have attempted to combine immune-directed therapies to peculiar invasive phenotypes [64,78,80].”
BackgroundNADPH Oxidases as Regulators of Tumor Angiogenesis: Current and Emerging Concepts
Coso, S., Harrison, I., Harrison, C. B., Vinh, A., Sobey, C. G., Drummond, G. R., Williams, E. D., & Selemidis, S. (2012) · Antioxidants and Redox Signaling · doi:10.1089/ars.2011.4489 · Cited by 101
“The second suggests that angiogenesis and the revascularization after conventional antiangiogenic drug therapy are caused by chronic inflammation (18, 33, 127).”
Development of Molecularly Targeted Therapies in Hepatocellular Carcinoma: Where Do We Go Now?
Finn, R. S. (2010) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-09-2084 · Cited by 99
Optimal Management of Metastatic Renal Cell Carcinoma: Current Status
Escudier, B. J., Albiges, L. K., & Sonpavde, G. (2013) · Drugs · doi:10.1007/s40265-013-0043-1 · Cited by 98
“upregulate HIF (Hypoxia Inducible Factor), a transcription factor that binds to DNA and leads to the production of multiple proangiogenic molecules including VEGF [5].”
BackgroundConvergence of VEGF and YAP/TAZ signaling: Implications for angiogenesis and cancer biology
Elaimy, A. L., & Mercurio, A. M. (2018) · Science Signaling · doi:10.1126/scisignal.aau1165 · Cited by 100
“This observation may explain, in part, the dismal efficacy of bevacizumab for many cancers (38, 39), and it highlights the potential benefit of directly targeting the NRPs as an approach to inhibiting VEGF signaling in CSCs.”
BackgroundRegulation of redox signaling in HIF‐1‐dependent tumor angiogenesis
Manuelli, V., Pecorari, C., Filomeni, G., & Zito, E. (2021) · FEBS Journal · doi:10.1111/febs.16110 · Cited by 107
The role of bone-marrow-derived cells in tumor growth, metastasis initiation and progression
Gao, D., & Mittal, V. (2009) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2009.06.006 · Cited by 99
Nanoparticulate immunotherapy for cancer
Kapadia, C. H., Perry, J. L., Tian, S., Luft, J. C., & DeSimone, J. M. (2015) · Journal of Controlled Release · doi:10.1016/j.jconrel.2015.09.062 · Cited by 98
“The benefits are at best transitory and are followed by a restoration of tumor growth and progression [97].”
BackgroundBuczek, M. E., Escudier, B. J., Bartnik, E., Szczylik, C. A., & Czarnecka, A. M. (2013) · Biochimica et Biophysica Acta (BBA) - Reviews on Cancer · doi:10.1016/j.bbcan.2013.10.001 · Cited by 100
“U N C O R R E C support for vasculature in the absence of VEGF-mediated signaling, which is supported by the fact that vessels lacking pericyte coverage are more vulnerable to anti-VEGF therapy [17,53] and that pericytes are able to express considerable levels of VEGF and other factors supporting survival of endotheli…”
BackgroundResultZhang, X., Wang, Y., Fan, J., Chen, W., Luan, J., Mei, X., Wang, S., Li, Y., Ye, L., Li, S., et al. (2019) · Journal for ImmunoTherapy of Cancer · doi:10.1186/s40425-019-0812-9 · Cited by 95
Yang, Q., Lei, X., He, J., Peng, Y., Zhang, Y., Ling, R., Wu, C., Zhang, G., Zheng, B., Chen, X., et al. (2023) · Advanced Science · doi:10.1002/advs.202300898 · Cited by 97
Role of the tumor stroma in resistance to anti-angiogenic therapy
Huijbers, E. J. M., B, J. R. V. B., Thijssen, V. L., Sabrkhany, S., Nowak-Sliwinska, P. M., & Griffioen, A. W. (2016) · Drug Resistance Updates · doi:10.1016/j.drup.2016.02.002 · Cited by 97
Pham, E., Birrer, M. J., Eliasof, S. D., Garmey, E. G., Lazarus, D. D., Lee, C. R., Man, S., Matulonis, U. A., Peters, C. G., Xu, P., et al. (2014) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-14-2810 · Cited by 94
Nanomaterials targeting tumor associated macrophages for cancer immunotherapy
Zhao, C., Pang, X., Yang, Z., Wang, S., Deng, H., & Chen, X. S. (2021) · Journal of Controlled Release · doi:10.1016/j.jconrel.2021.11.028 · Cited by 98
Progress toward Overcoming Hypoxia-Induced Resistance to Solid Tumor Therapy
Reginato, M., & Karakashev, S. (2015) · Cancer Management and Research · doi:10.2147/cmar.s58285 · Cited by 95
“Although some of the patients initially responded well and had regression of primary tumors, over time tumors became resistant and in many cases the tumors become more aggressive and contain increased metastasis.(126) One possibility is that antiangiogenic therapy promotes hypoxia that activates survival, invasion and…”
Targeting the Ras–ERK pathway in pancreatic adenocarcinoma
Neuzillet, C., Hammel, P. R., Tijeras‐Raballand, A., Couvelard, A., & Raymond, É. (2012) · Cancer and Metastasis Reviews · doi:10.1007/s10555-012-9396-2 · Cited by 97
Zhang, W., Sun, H., Wang, W., Zhang, Q., Zhuang, P., Xiong, Y., Zhu, X., Xu, H., Kong, L., Wu, W., et al. (2012) · Gastroenterology · doi:10.1053/j.gastro.2012.08.032 · Cited by 95
Cenik, B. K., Ostapoff, K. T., Gerber, D. E., & Brekken, R. A. (2013) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.mct-12-0995 · Cited by 94
“antiangiogenic therapies targeting VEGF have shown only modest clinical effect and are prone to resistance in many disease contexts (1).”
BackgroundCheng, A., Thongprasert, S., Lim, H. Y., Sukeepaisarnjaroen, W., Yang, T., Wu, C., Chao, Y., Chan, S. L., Kudo, M., Ikeda, M., et al. (2016) · Hepatology · doi:10.1002/hep.28600 · Cited by 95
“occur due to FGFR pathway activation.((22)) In addition to VEGFR and PDGFR, dovitinib inhibits FGFR((23)) and has been hypothesized to provide more effective and sustainable antitumor activity in patients with advanced HCC.”
InfluentialContribution of pericyte paracrine regulation of the endothelium to angiogenesis
Caporali, A., Martello, A., Miscianinov, V., Maselli, D., Vono, R., & Spinetti, G. (2016) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2016.10.001 · Cited by 96
“Some vessels especially those surrounding the tumor, are highly covered and this creates a sort of barrier impeding the access to the cells of the immune system and to therapeutic agents (Bergers & Hanahan, 2008).”
BackgroundTherapy for Cancer: Strategy of Combining Anti-Angiogenic and Target Therapies
Comunanza, V., & Bussolino, F. (2017) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2017.00101 · Cited by 99
“The reasons of this discrepancy have been partially understood and well addressed in many reviews (Bergers and Hanahan, 2008; Bottsford-Miller et al., 2012; El-Kenawi and El-Remessy, 2013; Wang et al., 2015; Jayson et al., 2016).”
BackgroundMissiaen, R., Mazzone, M., & Bergers, G. (2018) · Seminars in Cancer Biology · doi:10.1016/j.semcancer.2018.06.002 · Cited by 96
“These imply at least two major relapse categories, in which tumors either reinstate growth by revascularization or alter their growth behavior without obligate neovascularization [121].”
Self-citationDjokovic, D., Trindade, A., Gigante, J., Badenes, M., Silva, L., Liu, R., Li, X., Gong, M., Krasnoperov, V. G., Gill, P. S., et al. (2010) · BMC Cancer · doi:10.1186/1471-2407-10-641 · Cited by 99
“Rapid development of resistance to these [2], however, highlights the need for other vascular targeted therapies.”
BackgroundMethodCombination Strategy Targeting VEGF and HGF/c-met in Human Renal Cell Carcinoma Models
Ciamporcero, E. S., Miles, K. M., Adelaiye-Ogala, R. M., Ramakrishnan, S., Shen, L., Ku, S., Pizzimenti, S., Sennino, B., Barrera, G., & Пили, Р. (2014) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.mct-14-0094 · Cited by 93
“upregulation of alternative proangiogenic signals, and an increase of the invasive and metastatic behavior of tumor cells have been reported to play an important role (12, 13).”
BackgroundTRPV4 channels regulate tumor angiogenesis via modulation of Rho/Rho kinase pathway
Thoppil, R. J., Cappelli, H. C., Adapala, R. K., Kanugula, A. K., Paruchuri, S. M., & Thodeti, C. K. (2016) · Oncotarget · doi:10.18632/oncotarget.8405 · Cited by 97
Damage effect of high-intensity focused ultrasound on breast cancer tissues and their vascularities
Guan, L., & Xu, G. (2016) · World Journal of Surgical Oncology · doi:10.1186/s12957-016-0908-3 · Cited by 94
“Our current inability to identify which patients truly benefit from anti-angiogenic agents may be the real reason for the survival outcome of these trials [13, 14].”
BackgroundCytosolic Phospholipase A2 and Lysophospholipids in Tumor Angiogenesis
Linkous, A. G., Yazlovitskaya, E. M., & Hallahan, D. E. (2010) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djq290 · Cited by 96
“However, although several angiogenesis inhibitors have produced an enhanced clinical benefit, many of these pharmacological agents result in only transitory improvements that are followed by increased tumor resistance (42).”
BackgroundInterferon-α as angiogenesis inhibitor: Learning from tumor models
Indraccolo, S. (2010) · Autoimmunity · doi:10.3109/08916930903510963 · Cited by 94
Resistance to Anti-angiogenic Therapies: A Mechanism Depending on the Time of Exposure to the Drugs
Montemagno, C., & Pagès, G. (2020) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2020.00584 · Cited by 100
“The main chemo-attractants for EPCs in tumor tissue are VEGFA and SDF1, released by ECs, cancer cells and CAFs (Orimo et al., 2005; Grunewald et al., 2006).”
BackgroundInfluentialTargeting Tie2 in the Tumor Microenvironment: From Angiogenesis to Dissemination
Duran, C. L., Borriello, L., Karagiannis, G. S., Entenberg, D. R., Oktay, M. H., & Condeelis, J. S. (2021) · Cancers · doi:10.3390/cancers13225730 · Cited by 90
Chemotherapy in metastatic renal cell carcinoma today? A systematic review
Buti, S., Bersanelli, M., Sikokis, A., Maines, F., Facchinetti, F., Bria, E., Ardizzoni, A., Tortora, G., & Massari, F. (2013) · Anti-Cancer Drugs · doi:10.1097/cad.0b013e3283609ec1 · Cited by 93
Antiangiogenic drugs in ovarian cancer
Kumaran, G., Jayson, G. C., & Clamp, A. R. (2008) · British Journal of Cancer · doi:10.1038/sj.bjc.6604767 · Cited by 93
“Several other resistance mechanisms have also been proposed including the recruitment of vascular progenitor cells and monocytes from bone marrow as well as the increased protection from better pericyte coverage (Bergers and Hanahan, 2008).”
BackgroundAngiogenesis in Neuroendocrine Tumors: Therapeutic Applications
Scoazec, J. (2012) · Neuroendocrinology · doi:10.1159/000338371 · Cited by 95
iNGR-modified PEG-PLGA nanoparticles that recognize tumor vasculature and penetrate gliomas
Kang, T., Gao, X., Hu, Q., Jiang, D., Feng, X., Zhang, X., Song, Q., Yao, L., Huang, M., Jiang, X., et al. (2014) · Biomaterials · doi:10.1016/j.biomaterials.2014.01.082 · Cited by 93
“The disappointing outcomes are probably resulted from the high complexity of tumor angiogenesis regulation and insufficient tumor cell cytotoxicity, so it is desirable to also target the tumor cells within the bulk of tumor [47,48].”
BackgroundSato, M., Yao, V. J., Arap, W., & Pasqualini, R. (2010) · Advances in genetics · doi:10.1016/s0065-2660(10)69006-2 · Cited by 92
Targeting the Angiopoietin-2/Tie-2 axis in conjunction with VEGF signal interference
Biel, N. M., & Siemann, D. W. (2014) · Cancer Letters · doi:10.1016/j.canlet.2014.09.035 · Cited by 95
“Even though VEGF is a major driver of angiogenesis there are other growth factors such as basic FGF, interleukin-8 (IL-8), PlGF, PDGF, and IGF that can compensate in the absence of VEGF pathway activation [12,59].”
BackgroundInfluentialCarbone, C., Moccia, T., Zhu, C., Paradiso, G., Budillon, A., Chiao, P. J., Abbruzzese, J. L., & Melisi, D. (2011) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-11-1185 · Cited by 92
“The X-axis represents the log (10) P value for enrichment, with the threshold drawn at P 1⁄4 0.”
Chen, P., Tang, C., Lin, L.-W., Tsai, C., Chu, C.-Y., Lin, T., & Huang, Y. (2017) · Journal of Hematology & Oncology · doi:10.1186/s13045-017-0390-6 · Cited by 93
“The development of an antiangiogenic target has been a common strategy for cancer therapy for a long time, but substantial benefits remain unrealized because tumors elicit evasive resistance [39].”
Background
Metadata
- Authors
- Bergers, G., & Hanahan, D.
- Affiliations
- University of California, San Francisco (US)
- Venue
- Nature Reviews Cancer
- Published
- 2008-08
- Volume
- 8
- Issue
- 8
- Pages
- 592-603
- ISSN
- 1474-175X (ISSN-L)
- 1474-1768
- PMC
- PMC2874834
- OpenAlex
- W2017322644
- Cited by
- 2,953
- References
- 101
- Citations by year
- 2026: 70 · 2025: 77 · 2024: 97 · 2023: 130 · 2022: 95 · 2021: 172 · 2020: 133 · 2019: 152 · 2018: 148 · 2017: 202 · 2016: 217 · 2015: 228 · 2014: 241 · 2013: 248 · 2012: 215
- FWCI
- 13.60
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature reviews. Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R01CA099948)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
- Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Keywords
- anti-angiogenic therapy, drug resistance, vascular endothelial growth factor, VEGF signaling, tumor angiogenesis, intrinsic resistance, combination therapy
- MeSH terms
- Humans, Neoplasms, Neovascularization, Pathologic, Signal Transduction, Drug Resistance, Neoplasm, Angiogenesis Inhibitors, Vascular Endothelial Growth Factors
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