The role of angiogenesis inhibitors in epithelial carcinoma of the ovary, fallopian tube, or peritoneum
- Michael J Birrer, MD, PhD
Michael J Birrer, MD, PhD
- Professor of Medicine
- Harvard Medical School
- Bradley J Monk, MD, FACS, FACOG
Bradley J Monk, MD, FACS, FACOG
- Division of Gynecologic Oncology
- Department of Obstetrics and Gynecology
- Creighton University School of Medicine
- St. Joseph’s Hospital and Medical Center
- Section Editors
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Professor of Gynecologic Oncology
- University of Washington
- Don S Dizon, MD, FACP
Don S Dizon, MD, FACP
- Section Editor – Gynecologic Oncology
- Clinical Co-Director, Gynecologic Oncology
- Founder and Director, The Oncology Sexual Health Clinic
- Massachusetts General Hospital Cancer Center
- Associate Professor of Medicine
- Harvard Medical School
Epithelial cancers of ovarian, fallopian tubal, and peritoneal origin exhibit similar clinical characteristics and behavior. As such, these are often combined and define epithelial ovarian cancer (EOC) in clinical trials and clinical practice. This topic will consider all three histologies under the heading EOC. EOC is the most common cause of death among women with gynecologic malignancies and the fifth leading cause of cancer death in women in the United States. Treatment generally requires aggressive surgical evaluation and the use of adjuvant chemotherapy. For those with recurrence, chemotherapy is the mainstay of treatment, with surgery reserved for select situations.
The development of a blood supply is a necessary prerequisite for tumor growth. A dominant factor controlling tumor angiogenesis is vascular endothelial growth factor (VEGF). Angiogenesis plays a fundamental role in normal ovarian physiology and in the pathogenesis of EOC, progression through ascites formation, and metastatic spread [1-3]. VEGF and VEGF receptor (VEGFR) are expressed in EOC, and increased VEGF expression has been associated with the development of malignant ascites [2,4]. These data provide the rationale for targeting VEGF and VEGFR in the treatment of EOC.
This topic will review the role of angiogenesis inhibitors in EOC. The treatment of EOC and a general overview of angiogenesis inhibitors are covered separately:
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