semaxinib and Hematologic-Neoplasms

Research on the formation of new blood vessels (angiogenesis) in general and vascular endothelial growth factor (VEGF) in particular is a major focus in biomedicine and has led to the clinical approval of the monoclonal anti- VEGF antibody bevazicumab; and the second-generation multitargeted receptor kinase inhibitors (RTKIs) sorafenib, sunitinib, and pazopanib. Although these agents show significant preclinical and clinical anti-cancer activity, they prolong overall survival of cancer patients for only months, followed by a restoration of tumor growth and progression. Therefore, there is a clear need to increase our understanding of tumor angiogenesis and the development of resistance. In this review we discuss up-to-date knowledge on mechanisms of tumor angiogenesis, and summarize preclinical and clinical data on existing and potential future anti-angiogenic agents and treatment strategies for Multiple Myeloma (MM) and other hematologic and solid malignancies.

Topics: Angiogenesis Inhibitors; Antibodies, Monoclonal; Benzenesulfonates; Hematologic Neoplasms; Humans; Indoles; Multiple Myeloma; Neovascularization, Pathologic; Niacinamide; Phenylurea Compounds; Phthalazines; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Pyridines; Pyrroles; Receptors, Vascular Endothelial Growth Factor; Signal Transduction; Sorafenib; Sunitinib; Thalidomide; Vascular Endothelial Growth Factor A; Wnt Signaling Pathway

The vascularization is a very important part of a structure of each tissue both normal, including bone marrow stroma, and pathologically changed. Neoplastic tissues secure supplying in necessary substances for growth and expansion through regulated by its own cells neovasculation. Key role in multipotential cell's differentiation to endothelial cells plays regulatory system consisted of vascular-epithelial growth factor's family (VEGF B, C, D), receptors VEGFR-1, -2, -3, and system Tie2/angiopoetins. Stimulation and importance of angiogenesis for expansion of neoplastic diseases is a current problem in oncology. It is pointed to importance of neovascularization in pathogenesis of acute and chronic leukemias, lymphomas and multiple myeloma. The knowledge of the importance ofvascularization of neoplastic tissues is availing in therapy (researching of substances inhibiting angiogenesis--semaxinib, SU6668, ZD 6474, thalidomid, cetuximab, gefitinib, interferon-alpha, irradiation and others), in diagnostics as a monitoring of a success of the therapy, and in prognosis. Inhibitors ofangiogenesis are antineoplastic drugs with relatively lower toxicity, and lower risk of drug-resistance than conventional chemotherapy what has the importance especially during prolong administration, so they can be an alternative way of therapeutic process. During qualification for antiangiogenic therapy it is necessary to have a consciousness of its limited efficiency.

Topics: Angiogenesis Inducing Agents; Angiogenesis Inhibitors; Angiopoietin-1; Angiopoietin-2; Hematologic Neoplasms; Humans; Indoles; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemia, Myeloid, Acute; Multiple Myeloma; Myelodysplastic Syndromes; Neoplasm Metastasis; Neovascularization, Pathologic; Oxindoles; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Propionates; Pyrroles; Receptor, TIE-2; Receptors, Vascular Endothelial Growth Factor; Vascular Endothelial Growth Factors

Angiogenesis is an important component in the progression and metastasis of solid tumors. We now appreciate that angiogenesis is also critically involved in the pathogenesis of hematologic malignancies. Current data suggest important prognostic and therapeutic implications of angiogenesis in a variety of malignancies of the hematopoietic system, including acute and chronic leukemias, myeloproliferative diseases, multiple myeloma, non-Hodgkin's lymphomas, and Hodgkin's disease. Vascular endothelial growth factor (VEGF) is a major angiogenic factor that regulates multiple endothelial cell functions, including mitogenesis. Cellular and circulating levels of VEGF are elevated in hematologic malignancies and are adversely associated with prognosis. Angiogenesis is a very complex, tightly regulated, multistep process, the targeting of which may well prove useful in the creation of novel therapeutic agents. Current approaches being investigated include the inhibition of angiogenesis stimulants (e.g., VEGF), or their receptors, blockade of endothelial cell activation, inhibition of matrix metalloproteinases, and inhibition of tumor vasculature. Preclinical, phase I, and phase II studies of both monoclonal antibodies to VEGF and blockers of the VEGF receptor tyrosine kinase pathway indicate that these agents are safe and offer potential clinical utility in patients with hematologic malignancies.

Topics: Angiogenesis Inhibitors; Antibodies, Monoclonal; Disease Progression; Endothelial Growth Factors; Enzyme Inhibitors; Hematologic Neoplasms; Humans; Indoles; Lymphokines; Matrix Metalloproteinases; Neovascularization, Pathologic; Protein-Tyrosine Kinases; Pyrroles; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors