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Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply
Traditional treatments for intermediate or advanced stage hepatocellular carcinoma (HCC) such as transarterial chemoembolization (TACE) and anti-angiogenesis therapies were developed to starve tumor blood supply. A new approach of normalizing structurally and functionally abnormal tumor vasculature...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518951/ https://www.ncbi.nlm.nih.gov/pubmed/28617447 http://dx.doi.org/10.1038/ctg.2017.28 |
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author | Liu, Ken Zhang, Xiang Xu, Weiqi Chen, Jinbiao Yu, Jun Gamble, Jennifer R McCaughan, Geoffrey W |
author_facet | Liu, Ken Zhang, Xiang Xu, Weiqi Chen, Jinbiao Yu, Jun Gamble, Jennifer R McCaughan, Geoffrey W |
author_sort | Liu, Ken |
collection | PubMed |
description | Traditional treatments for intermediate or advanced stage hepatocellular carcinoma (HCC) such as transarterial chemoembolization (TACE) and anti-angiogenesis therapies were developed to starve tumor blood supply. A new approach of normalizing structurally and functionally abnormal tumor vasculature is emerging. While TACE improves survival in selected patients, the resulting tumor hypoxia stimulates proliferation, angiogenesis, treatment resistance and metastasis, which limits its overall efficacy. Vessel normalization decreases hypoxia and improves anti-tumor immune infiltrate and drug delivery. Several pre-clinical agents aimed at normalizing tumor vasculature in HCC appear promising. Although anti-angiogenic agents with vessel normalizing potential have been trialed in advanced HCC with modest results, to date their primary intention had been to starve the tumor. Judicious use of anti-angiogenic therapies is required to achieve vessel normalization yet avoid excessive pruning of vessels. This balance, termed the normalization window, is yet uncharacterized in HCC. However, the optimal class, dose and schedule of vascular normalization agents, alone or in combination with other therapies needs to be explored further. |
format | Online Article Text |
id | pubmed-5518951 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-55189512017-07-24 Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply Liu, Ken Zhang, Xiang Xu, Weiqi Chen, Jinbiao Yu, Jun Gamble, Jennifer R McCaughan, Geoffrey W Clin Transl Gastroenterol Clinical and Systematic Reviews Traditional treatments for intermediate or advanced stage hepatocellular carcinoma (HCC) such as transarterial chemoembolization (TACE) and anti-angiogenesis therapies were developed to starve tumor blood supply. A new approach of normalizing structurally and functionally abnormal tumor vasculature is emerging. While TACE improves survival in selected patients, the resulting tumor hypoxia stimulates proliferation, angiogenesis, treatment resistance and metastasis, which limits its overall efficacy. Vessel normalization decreases hypoxia and improves anti-tumor immune infiltrate and drug delivery. Several pre-clinical agents aimed at normalizing tumor vasculature in HCC appear promising. Although anti-angiogenic agents with vessel normalizing potential have been trialed in advanced HCC with modest results, to date their primary intention had been to starve the tumor. Judicious use of anti-angiogenic therapies is required to achieve vessel normalization yet avoid excessive pruning of vessels. This balance, termed the normalization window, is yet uncharacterized in HCC. However, the optimal class, dose and schedule of vascular normalization agents, alone or in combination with other therapies needs to be explored further. Nature Publishing Group 2017-06 2017-06-15 /pmc/articles/PMC5518951/ /pubmed/28617447 http://dx.doi.org/10.1038/ctg.2017.28 Text en Copyright © 2017 The Author(s) http://creativecommons.org/licenses/by-nc-nd/4.0/ Clinical and Translational Gastroenterology is an open-access journal published by Nature Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Clinical and Systematic Reviews Liu, Ken Zhang, Xiang Xu, Weiqi Chen, Jinbiao Yu, Jun Gamble, Jennifer R McCaughan, Geoffrey W Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply |
title | Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply |
title_full | Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply |
title_fullStr | Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply |
title_full_unstemmed | Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply |
title_short | Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply |
title_sort | targeting the vasculature in hepatocellular carcinoma treatment: starving versus normalizing blood supply |
topic | Clinical and Systematic Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518951/ https://www.ncbi.nlm.nih.gov/pubmed/28617447 http://dx.doi.org/10.1038/ctg.2017.28 |
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