Endostatin and Cancer Therapy: A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies

Abstract

Angiogenesis is a physiological process that consists of the formation of new blood vessels from preexisting ones. Angiogenesis helps in growth, development, and wound healing through the formation of granulation tissue. However, this physiological process has also been linked to tumor growth and metastasis formation. Indeed, angiogenesis has to be considered as a fundamental step to the evolution of benign tumors into malignant neoplasms. The main mediator of angiogenesis is vascular endothelial growth factor (VEGF), which is overexpressed in certain cancers. Thus, there are anti-VEGF monoclonal antibodies, such as bevacizumab, used as anti-cancer therapies. However, bevacizumab has shown adverse events, such as hypertension and proteinuria, which in the most severe cases can lead to cessation of therapy, thus contributing to worsening patients’ prognosis. On the other hand, endostatin is an endogenous protein that strongly inhibits VEGF expression and angiogenesis and shows a better safety profile. Moreover, endostatin has already given promising results on small scale clinical studies. Hence, in this review, we present data supporting the use of endostatin as a replacement for anti-VEGF monoclonal antibodies.

The Depth of the Molecular Response in Patients with Chronic Myeloid Leukemia Correlates with Changes in Humoral Immunity

“…We observed that a decreased endostatin concentration at the baseline was linked with an early molecular response in the 3rd month. Endostatin, which acts as an angiogenesis inhibitor, is a promising object of research in the treatment of solid tumors [10]. The importance of endostatin in CML has not been elucidated.…”

The effective combination therapies with irinotecan for colorectal cancer

“…Among them, Vascular endothelial growth factor A (VEGF-A) is a major mediator of tumor angiogenesis and induces angiogenesis through direct action on endothelial cells. VEGF-A activates VEGF signaling in endothelial cells by binding to VEGF rceptor-1 (VEGFR-1) and VEGF receptor-2 (VEGFR-2) ( Méndez-Valdés et al, 2023 ). VEGFR-2 is mainly involved in tumor pathological processes such as tumor angiogenesis and is the most important inducer, and VEGFR-1 plays an important role mainly in tumor growth and progressive inflammatory processes ( Melincovici et al, 2018 ).…”

Dual effects of radiotherapy on tumor microenvironment and its contribution towards the development of resistance to immunotherapy in gastrointestinal and thoracic cancers

“…A recent study with PEGylated recombinant human endostatin indicated the potential of this anti-angiogenic substance for the treatment of pancreatic and gastric cancers ( Guo L. et al, 2023 ). Endostatin can not only block cancer-induced VEGF expression, but also demonstrated a better safety profile (compared to bevacizumab) in small clinical studies ( Mendez-Valdes et al, 2023 ), although further testing with combined radiotherapy is required.…”