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Targeting Angiogenesis in Prostate Cancer

Department of Cellular Pathology, Southmead Hospital, Bristol BS10 5NB, UK
Institute of Biomedical and Clinical Sciences, Medical School, College of Medicine and Health, University of Exeter, Exeter EX12LU, UK
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(11), 2676;
Received: 7 May 2019 / Revised: 24 May 2019 / Accepted: 29 May 2019 / Published: 31 May 2019
Prostate cancer is the most commonly diagnosed cancer among men in the Western world. Although localized disease can be effectively treated with established surgical and radiopharmaceutical treatments options, the prognosis of castration-resistant advanced prostate cancer is still disappointing. The objective of this study was to review the role of angiogenesis in prostate cancer and to investigate the effectiveness of anti-angiogenic therapies. A literature search of clinical trials testing the efficacy of anti-angiogenic therapy in prostate cancer was performed using Pubmed. Surrogate markers of angiogenic activity (microvessel density and vascular endothelial growth factor A (VEGF-A) expression) were found to be associated with tumor grade, metastasis, and prognosis. Six randomizedstudies were included in this review: two phase II trials on localized and hormone-sensitive disease (n = 60 and 99 patients) and four phase III trials on castration-resistant refractory disease (n = 873 to 1224 patients). Although the phase II trials showed improved relapse-free survival and stabilisation of the disease, the phase III trials found increased toxicity and no significant improvement in overall survival. Although angiogenesis appears to have an important role in prostate cancer, the results of anti-angiogenic therapy in castration-resistant refractory disease have hitherto been disappointing. There are various possible explanations for this lack of efficacy in castration-resistant refractory disease: redundancy of angiogenic pathways, molecular heterogeneity of the disease, loss of tumor suppressor protein phosphatase and tensin homolog (PTEN) expression as well as various VEGF-A splicing isoforms with pro- and anti-angiogenic activity. A better understanding of the molecular mechanisms of angiogenesis may help to develop effective anti-angiogenic therapy in prostate cancer. View Full-Text
Keywords: prostate cancer; angiogenesis; VEGF-A; splicing isoforms prostate cancer; angiogenesis; VEGF-A; splicing isoforms
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MDPI and ACS Style

Melegh, Z.; Oltean, S. Targeting Angiogenesis in Prostate Cancer. Int. J. Mol. Sci. 2019, 20, 2676.

AMA Style

Melegh Z, Oltean S. Targeting Angiogenesis in Prostate Cancer. International Journal of Molecular Sciences. 2019; 20(11):2676.

Chicago/Turabian Style

Melegh, Zsombor, and Sebastian Oltean. 2019. "Targeting Angiogenesis in Prostate Cancer" International Journal of Molecular Sciences 20, no. 11: 2676.

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