Nepal Journal of Neuroscience
Official Journal of Nepalese Society of Neurosurgeons
www.neuroscience.org.np
www.neson.org.np


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Tumor Angiogenesis: Clinical Implications.

Yogendra Singh, MD, PhD
Department of Surgery (Surgical Oncology) Tribhuvan University Teaching Hospital Kathmandu, Nepal

Abstract
Tumor angiogenesis is the formation of new blood vessels from the preexisting vessels, which is normally initiated by the dissolution of the parent vessel basement membrane and endothelial migration into the stroma, forming the angiogenic stimulus. This process is crucial for the progression of solid tumors as well as hematogenous malignancies. The induction of angiogenesis is mediated by several angiogenic molecules released by both tumor and host cells. The prevascular stage of the tumor is associated with local benign behavior, whereas the vascular stage is associated with rapid tumor growth and eventual metastases. Tumor angiogenesis has both predictive as well as therapeutic implications. Several clinical studies have correlated the extent of angiogenesis with prognosis of cancer patients. An assessment of tumor microvessel count in biopsy specimens can be useful prognostically. Inhibition of angiogenesis prevents the growth of tumor cells at the primary as well as secondary sites. Anti-angiogenic therapy may provide a novel approach to the management of various cancer patients. Angiogenesis inhibitors can be co-administered with cytotoxic chemotherapy or radiotherapy to achieve synergistic antitumor effects. This paper will highlight the key principles of tumor angiogenesis. An overview of predictive as well as therapeutic implications will also be provided.

Key Words: angiogenesis inhibitors, combination therapy, microvessel count, tumor angiogenesis