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FUNDAMENTALS OF CANCER MEDICINE |
David S. Goodsell, Ph.D., Associate Professor, The Scripps Research Institute, Department of Molecular Biology, 10550 North Torrey Pines Road, La Jolla, California 92037, USA. Telephone: 858-784-2839; Fax: 858-784-2860; e-mail: goodsell{at}scripps.edu Website: http://www.scripps.edu/pub/goodsell
Our cells need a constant supply of oxygen to power their diverse molecular processes. This oxygen is delivered by the blood, so nearly all of our cells are within a tenth of a millimeter from a blood capillary. Tumor cells are no exception. If a collection of cancerous cells grows much larger than a millimeter, it will starve itself of oxygen and energy unless new blood vessels are built to provide a supply. For this reason, many cancer cells co-opt the normal processes of angiogenesis, the development of blood vessels, in order to build their own blood supply.
Vascular endothelial growth factor, or VEGF (shown in Fig. 1
), is the key signal used by oxygen-hungry cells to promote growth of blood vessels. It binds to specialized receptors on the surfaces of endothelial cells (shown in Fig. 2
) and directs them to build new vessels. After receiving this message, the cells build specialized proteases to break through the basal lamina, and migrate into the oxygen-starved region. Once there, the cells multiply and form into tubes, creating a new path for blood to flow.
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As you can imagine, this is an attractive process for the design of cancer therapy. By selectively inhibiting the growth of new blood vessels, we can starve tumor cells. Effective methods have been developed to do just this, using drugs or antibodies to block the formation of VEGF or the binding of VEGF to its receptors. Researchers have found, however, that these methods are effective for stopping the growth of a tumor, but generally not for reducing the size of an existing tumor. They are powerful tools, however, when used in combination with agents that attack other key points in the tumor cell.
FURTHER READING
Saaristo A, Karpanen T, Alitalo K. Mechanisms of angiogenesis and their use in the inhibition of tumor growth and metastasis. Oncogene 2000;19:61226129.[CrossRef][Medline]
Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000;100:5770.[CrossRef][Medline]
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