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Targeting Angiogenesis in the Treatment of Hepatic Metastasis

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Liver Metastasis: Biology and Clinical Management

Part of the book series: Cancer Metastasis - Biology and Treatment ((CMBT,volume 16))

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Abstract

The liver is the most common site for the development of metastases from gastrointestinal malignancies. Although the only potentially curative option for patients with liver metastases is resection, only a minority are candidates. In order to increase the number of patients who may be candidates for resection, preoperative systemic chemotherapy and targeted therapy approaches have been utilized. Angiogenesis has been shown to be integral for the growth and metastasis of many tumor types including the development of liver metastases. The development of anti-angiogenic approaches, particularly anti vascular endothelial growth factor (VEGF) therapy with bevacizumab, has shown great promise in the treatment of patients with liver metastases, particularly from colorectal cancer and to a lesser degree, neuroendocrine carcinoma. These approaches have allowed physicians to increase the number of patients that may be amenable for curative resection. As angiogenesis and VEGF have been shown to be important in liver hypertrophy and regeneration, however, the possible effects of anti-VEGF therapy on liver recovery may carry significant risks along with the potential benefits.

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Abbreviations

Ang:

angiopoietin

BEAT:

Bevacizumab Expanded Access Trial

BV:

bevacizumab

CRC:

colorectal cancer

FDA:

Food and Drug Administration

FGF:

fibroblast growth factor

FLR:

future liver remnant

5-FU:

5-fluorouracil

GI:

gastrointestinal

GIST:

gastrointestinal stromal tumors

HCC:

hepatocelluar carcinoma

HGF:

hepatocyte growth factor

HIF:

hypoxia-inducible factor

IGF:

insulin growth factor

LV:

leucovorin

mCRC:

metastatic colorectal cancer

OS:

overall survival

PD:

progressive disease

PFS:

progression-free survival

PlGF:

placental growth factor

PR:

partial response

PVE:

portal vein embolization

PVO:

portal vein occlusion

RCC:

renal cell carcinoma

SD:

stable disease

SWOG:

Southwestern Oncology Group

TKI:

tyrosine kinase inhibitor

VEGF:

vascular endothelial growth factor

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Christina M. Edwards, J. Joshua Smith & Nipun B. Merchant

  2. Division of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, 597 Preston Building, 2220 Pierce Avenue, Nashville, TN, 37232-2730, USA

    Alexander A. Parikh

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  1. Christina M. Edwards
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  2. J. Joshua Smith
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  3. Nipun B. Merchant
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  4. Alexander A. Parikh
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Correspondence to Alexander A. Parikh .

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Editors and Affiliations

  1. Royal Victoria Hospital, Division of Surgical Research, McGill University Health Centre, Pine Ave W. 687, Montreal, H3A 1A1, Québec, Canada

    Pnina Brodt

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Edwards, C.M., Smith, J.J., Merchant, N.B., Parikh, A.A. (2011). Targeting Angiogenesis in the Treatment of Hepatic Metastasis. In: Brodt, P. (eds) Liver Metastasis: Biology and Clinical Management. Cancer Metastasis - Biology and Treatment, vol 16. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0292-9_15

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