Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply.
Targeting the vasculature in hepatocellular carcinoma treatment: Starving versus normalizing blood supply.
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DOI：
10.1038/ctg.2017.28
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发表时间：
2017-06-15
影响因子：
3.6
通讯作者：
McCaughan GW
中科院分区：
文献类型：
--
作者：
Liu K;Zhang X;Xu W;Chen J;Yu J;Gamble JR;McCaughan GW
传统的治疗中晚期肝细胞癌的方法，如肝动脉化疗栓塞术(TACE)和抗血管生成治疗，都是为了减少肿瘤的血供。一种使结构和功能异常的肿瘤血管正常化的新方法正在出现。虽然TACE提高了部分患者的存活率，但由此产生的肿瘤缺氧刺激了增殖、血管生成、治疗耐药和转移，从而限制了其整体疗效。血管正常化减少缺氧，改善抗肿瘤免疫渗透和药物输送。几种旨在使肝细胞癌肿瘤血管正常化的临床前药物似乎很有希望。尽管具有血管正常化潜力的抗血管生成药物已经在晚期肝癌中进行了试验，效果不大，但到目前为止，它们的主要目的是让肿瘤挨饿。为了实现血管正常化，同时避免过度修剪血管，需要明智地使用抗血管生成疗法。这种平衡，被称为正常化窗口，在肝细胞癌中尚无特征。然而，血管正常化药物的最佳种类、剂量和方案，无论是单独使用还是与其他疗法联合使用，都需要进一步探索。
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.
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DOI：
10.1097/coc.0b013e3182118cdf
发表时间：
2012-08
期刊：
American journal of clinical oncology
影响因子：
--
作者：
Alberts SR;Fitch TR;Kim GP;Morlan BW;Dakhil SR;Gross HM;Nair S
通讯作者：
Nair S
表皮生长因子受体抑制通过血管正常化调节微环境，从而提高化疗和放疗疗效。
影响因子：
3.7
作者：
Cerniglia, George J.;Pore, Nabendu;Tsai, Jeff H.;Schultz, Susan;Mick, Rosemarie;Choe, Regine;Xing, Xiaoman;Durduran, Turgut;Yodh, Arjun G.;Evans, Sydney M.;Koch, Cameron J.;Hahn, Stephen M.;Quon, Harry;Sehgal, Chandra M.;Lee, William M. F.;Maity, Amit
通讯作者：
Maity, Amit
影响因子：
168.9
作者：
Escudier, Bernard;Pluzanska, Anna;Moore, Nicola
通讯作者：
Moore, Nicola
影响因子：
3.9
作者：
Bernsen, HJJA;Rijken, PFJW;van der Kogel, AJ
通讯作者：
van der Kogel, AJ
影响因子：
13.5
作者：
Bruix, J;Llovet, JM
通讯作者：
Llovet, JM