A review of angiogenesis and antiangiogenic therapy with thalidomide in multiple myeloma

被引:112
作者
Rajkumar, SV [1 ]
Witzig, TE [1 ]
机构
[1] Mayo Clin & Mayo Fdn, Div Hematol, Rochester, MN 55905 USA
关键词
multiple myeloma; angiogenesis; thalidomide; treatment; antiangiogenic therapy; VEGF; bFGF;
D O I
10.1053/ctrv.2000.0188
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Angiogenesis is the formation of new blood vessels and occurs physiologically during embryonal growth, wound healing and during the menstrual cycle, it is essential for the proliferation and metastases of most malignant neoplasms. Recent evidence suggests that angiogenesis is increased in multiple myeloma and has prognostic value in the disease. Angiogenic cytokines such as vascular endothelial growth factor (VEGF) and basic fibroblast growth Factor are expressed by myeloma cells and appear to play a role in the increased angiogenesis seen in myeloma. in addition,VEGF may serve as a paracrine growth factor for myeloma cells. Based on the increased angiogenesis observed in myeloma, thalidomide has been studied as antiangiogenic therapy Although its mechanism of action in myeloma is still unclear, thalidomide appears to be active in 25-30% of patients with refractory myeloma. Major toxicities include constipation, sedation, skin rash, fatigue, and peripheral neuropathy. Studies are ongoing to determine its role as initial treatment for myeloma. This paper reviews the available data on angiogenesis in myeloma, and summarizes the role of thalidomide therapy in this disease. The pharmacology and toxicity of thalidomide are also discussed. (C) 2000 Harcourt Publishers Ltd.
引用
收藏
页码:351 / 362
页数:12
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