The Use of Anti-angiogenic Factors in the Treatment of Oncologic Disease

1. The Use of Anti-angiogenic Factors in the Treatment of Oncologic Disease Kyle Treesh, PA-S Bob Hadley, Ph.D., PA-C, Advisor University of Kentucky

2. Learning Objectives • Why do we need new cancer treatments? • What is angiogenesis? • What are the anti-angiogenesis agents? • What agents are FDA-approved? • What combinations of treatment are best? • What does the future hold for these therapies?

3. U.S. Cancer Statistics • Cancer is a major public health problem! • One in four deaths is due to cancer (570,280 deaths in 2005) • 1,372,910 new cancer cases in 2005 • Lung and bronchus, and colon and rectum equal 25% of total cancer deaths • Breast and Prostate cancers are prevalent in their respective sexes

4. What is angiogenesis? • Think way back to pathophysiology… • Angiogenesis is the formation of blood vessels in a tissue initiated by VEGF and bfGF • Angiogenesis aids in the healing of wounds, proliferates the endometrium, and is a vital part of pregnancy • Tumors can also cause angiogenesis to occur in order to bring oxygen and nutrients to the tumor for growth • These new blood vessels are the vehicle for metastasis

5. Anti-angiogenesis factors • Protein anti-angiogenic agents • Monoclonal antibody anti-angiogenic agents • Metronomic chemotherapy

6. Bevacizumab/Avastin • 1st FDA-approved Angiogenesis Inhibitor • Approved for use with chemotherapy in the treatment of colorectal cancer • Prolonged lives 5 months compared to standard treatment • No additional side effects! • Not expected to be a cure, but provides hope for a longer life

7. Combination Therapies with Anti-angiogenesis agents: • With Chemotherapy • With Radiation • With other anti-angiogenesis agents • With Vascular Disrupting Agents • Metronomic Chemotherapy • Trimodal Therapy

8. Into the Future… • What are the limitations of these therapies? • Can these agents work in all cancer sites? • Could these agents be used for prevention of a recurrent cancer (e.g. Breast CA)? • Will clinicians use these therapies? • Over 50 angiogenesis inhibitors in ongoing clinical trials

9. The bottom line… • Angiogenesis inhibitors have the potential to prolong cancer patients’ quantity of life without diminishing their quality of life

10. For more information: • The American Cancer Society www.cancer.org • The National Cancer Institute www.cancer.gov

11. Questions?

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