Prognostic and Predictive Significance of Surrogate Biomarkers of Angiogenesis.

摘要: The identification of prognostic factors and the appropriate selection patients more likely to benefit anti-angiogenic therapies is a major area research. Early experience with other molecular targeted drugs, such as imatinib and/or trastuzumab, has generated perception that pre-treatment target assessment pre-requisite for therapy. However, emerging evidence suggests presently we have no predictive biomarkers agents. Despite considerable association intratumoral plasma vascular endothelial growth factor (VEGF) levels tumor progression poor prognosis, VEGF are not response angiogenesis inhibitors. This may possibly be due complexity angiogenic pathways limitations associated current methods detection quantification; e.g. low assay sensitivity lack standardized could prevent very small increases in VEGF, which clinically important. In addition general agreement relative clinical relevance circulating versus levels, absence gold standard’ predefined, relevant cut-off values pose significant hindrance utility measurements therapy selection. Several retrospective studies showed promising important role microvessel density pro-angiogenic (e.g. basic fibroblast factor, thymidine phosphorylase, etc.) indipendent markers solid tumors, but these data validated prospective trials.