Angiogenesis - still a worthwhile target for breast cancer therapy?

Tumour angiogenesis was identified as a target for cancer therapy in the 1970s. To date, one anti-angiogenesis treatment, bevacizumab, which targets the vascular endothelial growth factor (VEGF) signalling pathway, has been licensed for the treatment of advanced breast cancer. However, in clinical studies only modest improvements in progression-free survival have been seen for anti-angiogenic treatment of this disease (Table 1 ). Many patients have no response to these drugs at all, and often after an initial response patients soon relapse. Indeed, the US Food and Drug Administration (FDA) Oncologic Drugs Advisory Committee (ODAC) recently voted almost unanimously to remove the treatment of advanced breast cancer as a licensed indication for bevacizumab. Results from trials in the adjuvant and neoadjuvant setting for breast cancer are still awaited. We discuss why anti-angiogenesis therapies have not lived up to their early expectations and how new strategies for their use may lead to their greater effectiveness.