Targeting Angiogenesis in Ovarian Carcinoma

Ovarian carcinoma is the leading cause of gynecological cancer-related mortality. Cytoreductive surgery followed by combination chemotherapy including paclitaxel and a platinum compound usually results in complete remission in approximately 70% of patients. Despite this, the majority of patients will eventually relapse and die. There is, therefore, a crucial need to develop new therapeutic agents and better strategies to improve the outcome of these patients. Recently, tumor microenvironment has become an attractive target in gynecological malignancies. Angiogenesis is a complex and highly regulated process consisting in the development of new vessels from pre-existing ones. This process has been shown to have a main role in cancer beginning and progression. In ovarian cancer increased angiogenesis is associated with rapid recurrence and decreased survival. Moreover, targeting of vascular endothelial growth factor (VEGF) has produced promising results in early clinical trials, suggesting that angiogenesis plays a critical role in the development and maintenance of ovarian carcinomas. However, many questions remain open related to optimal dosing, sequencing of therapies, toxicities, patient selection, and response assessment. This article reviews the mechanisms of the angiogenic process and resumes the latest clinical studies of antivascular agents in ovarian carcinoma in a “from bench to bedside” approach.