Angiogenesis and antiangiogenic treatment in lung cancer

Angiogenic factors released by cancer cells increase structurally and functionally abnormal tumor micro-vascularization, resulting in metastases and progressive disease. Such diffusible factors bind to specific receptors of endothelial cells and activate the angiogenic signal pathway. Treatments with antiangiogenic monoclonal antibodies (e.g., bevacizumab) or using small molecules with anti-tyrosine kinase activity (e.g., sunitinib, sorafenib, ZD6474, erlotinib, or thalidomide) can block angiogenic signaling, lower blood tumoral irrigation, and improve chemotherapy distribution. Numerous studies have shown that a combination of biotherapy and chemotherapy can improve medical management of patients with advanced or metastatic non-small cell lung carcinomas. Biotherapy combination approaches also yield encouraging results promoting the development of targeted antitumor drugs.