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    ANTI-ANGIOGENESIS
    Cutting off cancer's fuel line

    Several approaches to anti-angiogenesis

    Cancer cells make many substances that cause cells in the lining of capillaries - the smallest blood vessels - to divide and reproduce, which is a part of angiogenesis. One line of experiments focuses on trying to stop the effect of substances (such as vascular endothelial growth factor, or VEGF) that stimulate angiogenesis.

    Another line of research focuses on stopping a subsequent step in the process of blood vessel formation. Certain enzymes, called metalloproteases, are needed to break down normal tissue to clear a pathway for the new blood vessels that feed tumors. Researchers are working on drugs to block the action of these specific proteases, thereby limiting growth of new blood vessels.

    Perspective

    More discoveries are possible as scientists learn more about the molecular biology of cancer cells and blood vessels. Yet the pace of discoveries - although rapid by the standards of science - is not fast enough for many cancer patients. Endostatin and angiostatin aren't expected to be ready for clinical trials in humans until at least next year. However, other clinical trials of anti-angiogenic drugs (also called angiogenic inhibitors) are underway, as well as trials of many other experimental treatments.

    * What are the appropriate regimens, methods of administration and doses?

    * Will people need to take them for the rest of their lives?

    * What are the potential side effects?

    * Who should take them, and when? (It's already speculated that pregnant women and people with healing wounds or who are recovering from surgery may have trouble using such drugs.)



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