Assessing metastasis risk after pre-operative anti-angiogenic therapy

Anti-angiogenic drugs are approved for the treatment of several cancer types, generally in the inoperable locally advanced or metastatic setting and in combination with other anti-cancer agents. Recent clinical studies also suggest that anti-angiogenic drugs can be useful in the pre-operative (neoadjuvant) setting, by facilitating the shrinkage of the primary tumour and its surgical resection. However, the effects of neoadjuvant anti-angiogenic therapy on the ability of tumours to form distant metastases are unclear. In this issue of EMBO Molecular Medicine, Ebos et al (2014) present carefully performed pre-clinical studies in mice that analyse the effects of pre-operative anti-angiogenic therapy on tumour metastasis and survival.