Researchers are now looking at many different aspects of anti-angiogenesis drugs. Better understanding of these drugs will probably make them a bigger part of cancer treatment in the future.

Figuring out how to best use these drugs

Several anti-angiogenesis drugs are now used to treat cancer, and others will be in the near future. Because these drugs are still new, many questions about them have not yet been answered. Do they work better when used alone or with other treatments? What's the best way to give them? How long should they be given? These and other important questions are now being studied in clinical trials.

Finding new drugs

As researchers learn more about the process of angiogenesis and its effects on tumor growth, they will be able to develop newer, better drugs to attack this process. Some of these new drugs will also target the cancer cells themselves.

Vascular disrupting agents (VDAs)

Also called vascular targeting agents (VTAs), these are a related group of drugs that may prove to be important in treating cancer. Anti-angiogenesis drugs stop new blood vessels from forming, but is there a way to attack tumor blood vessels that have already formed?

Researchers have found differences between normal blood vessels in the body and those that supply tumors. Some new drugs may be able to exploit these differences, attacking tumor blood vessels but leaving normal blood vessels alone.

Several VDAs are now being studied in clinical trials. Early studies have shown that these drugs seem to work best on the inner parts of tumors. This may mean they will work well when used with other treatments that are more likely to work on the outside of the tumor, such as chemotherapy.

Combining anti-angiogenesis drugs

It is now clear that tumors can make and release many chemicals that can start angiogenesis. Using a drug that targets only one of these chemicals may not have a large effect on the cancer, but combining drugs that attack different targets may prove to be more useful. Studies combining these drugs are now under way.

Combining angiogenesis with other treatments

Anti-angiogenesis drugs tend to have milder side effects that are different from other cancer treatments. This makes the idea of combining them with other types of treatment very appealing. Researchers are now combining these drugs with chemotherapy drugs, radiation therapy, or other types of targeted therapies. Early study results have been promising.

Using metronomic chemotherapy

Most chemotherapy drugs were designed to attack cancer cells directly. But doctors have found that some of them may be useful as anti-angiogenesis drugs, too. When they are given at low doses over a longer period of time they seem to work without causing major side effects (as opposed to giving high doses at regular intervals, which is how they are usually used).

This approach is known as metronomic chemotherapy. Some evidence suggests that when used this way, the chemotherapy may be acting on the tumors' blood vessels. Studies are being done to test the value of metronomic chemotherapy, either alone or combined with anti-angiogenic drugs.

Last Medical Review: 03/10/2009
Last Revised: 03/10/2009

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