Cancer remains one of the most strong challenges existing in modern medicine as of today, making it necessary to innovate strategies to combat its relentless progression. Out of the many strategies and approaches developed, angiogenesis inhibition has emerged as a groundbreaking method to fight the deadly cancer. By cutting off the tumor’s blood supply, angiogenesis inhibitors aim to starve the cancer cells, by limiting their growth and further spread. Let’s talk about the science behind the angiogenesis inhibitors, their development and their impact on cancer treatment.

Lets know more about Angiogenesis and Cancer

Angiogenesis is the formation of new blood vessels created from the original/pre-existing ones, this process is a natural and essential process for growth and healing in the human body. In context to cancer, this process is hijacked to supply tumors with the necessary nutrition and oxygen to proliferate. Tumors secrete specific growth factors, such as the vascular endothelial growth factor (VEGF), to stimulate angiogenesis, ensuring a steady blood supply that helps and supports rapid growth and metastasis.

Dr. Judah Folkman first proposed the concept of targeting the angiogenesis in cancer. This was first proposed in the early 1970’s where he hypothesized that by inhibiting angiogenesis it will be possible to starve tumors of their blood supply which will inhibit their growth and spread. This idea originated by Dr. Folkman laid the foundation for the development of Angiogenesis Inhibitors.

Mechanism of the Angiogenesis Inhibitors

Angiogenesis Inhibitors work by disrupting the signaling pathways that tumors use to promote blood vessel formation. There are various mechanisms through which the inhibitors function, let’s find out more:

1. VEGF Inhibitors: These are perhaps the most well-known angiogenesis inhibitors. They block the activity of VEGF, preventing it from binding to its receptors on the surface of endothelial cells (cells that line the blood vessels). Bevacizumab (Avastin) being one of the most prominent examples of the VEGF inhibitors used in treating cancer.
2. Tyrosine Kinase Inhibitors (TKIs) : These are small molecules that interfere with the receptors on the surface of endothelial cells that receive signals from the VEGF and other growth factors. By blocking these receptors, TKIs like sunitinib and sorafenib prevent the signaling necessary for angiogenesis.
3. Integrin Inhibitors : Integrins are the proteins involved in the adhesion and migration of endothelial cells during the formation of the new blood vessels. Integrin Inhibitors, such as cilengitide block these proteins, hindering the angiogenesis process.
4. Matrix Metalloproteinase (MMP) Inhibitors : MMPs are enzymes that break down the extracellular matrix, a necessary step for new blood vessel formation. MMP Inhibitors aim to prevent this breakdown, thereby blocking angiogenesis.

Impact on other Health Conditions

Angiogenesis Inhibitors have proven to be very effective in cancer treatment but at the same time they have their side effects too.

1. Eye Diseases – Age-Related Macular Degeneration (AMD) and Diabetic Retinopathy are the two most common side-effects of the Angiogenesis Inhibitors treatment. Angiogenesis Inhibitors like ranibizumab (Lucentis) and aflibercept (Eylea) are used to treat AMD, a leading cause of vision loss, by reducing the growth of abnormal blood vessels in the eye.
2. Rheumatoid Arthritis – There is ongoing research to understand the use of angiogenesis inhibitors in the treatment of Rheumatoid Arthritis, as new blood vessels formation is implicated in the inflammation and progression of this disease.

Challenges and Considerations

• Resistance Development
  • Adaptive Mechanism : Tumors can develop resistance to angiogenesis inhibitors through various mechanisms, such as upregulating alternative angiogenic pathways.
  • Combination Therapies : To counteract resistance, combination therapies with other anticancer drugs are often explored.

• Patient Selection
  • Biomarkers: Identifying patients who are most likely to benefit from angiogenesis inhibitors is an ongoing area of research, with efforts to discover reliable biomarkers for patient selection

• Cost & Accessibility
  • Economic Impact: The Angiogenesis Inhibitors treatment is a higher cost treatment then the Chemotherapy and Radiation treatments available for cancer. Thus making it a challenge for many patients to afford the same. It impacts the overall health economics and accessibility for this treatment.

Conclusion

As you know that Angiogenesis Inhibitors have a strong and powerful strategy to fight against cancer, by working on cutting the blood supply to the tumor cells, which need blood to spread and grow. However, the procedure is impactful, but the challenges, such as drug resistance and other side effects, remain as is. The ongoing and consistent research, however guarantees to enhance the efficiency and efficacy and bring more safety of these treatments. By the continuous efforts to explore and refine angiogenesis inhibition, the medical community in moving closer to achieve more effective and targeted therapies to treat cancer and serve the patients worldwide.