Anti-angiogenesis in colorectal cancer therapy

Abstract

The morbidity of colorectal cancer (CRC) has risen to third place among malignant tumors worldwide. In addition, CRC is a common cancer in China whose incidence increases annually. Angiogenesis plays an important role in the development of tumors because it can bring the nutrients that cancer cells need and take away metabolic waste. Various mechanisms are involved in the formation of neovascularization, and vascular endothelial growth factor is a key mediator. Meanwhile, angiogenesis inhibitors and drug resistance (DR) are challenges to consider when formulating treatment strategies for patients with different conditions. Thus, this review will discuss the molecules, signaling pathways, microenvironment, treatment, and DR of angiogenesis in CRC.

Keywords: VEGF; angiogenesis; colorectal cancer; drug resistance; therapy.

FIGURE 1

Full‐text mechanism diagram. In normal blood vessels, endothelial cells have tight junctions with a normal number of surrounding pericytes and intact basement membranes (BMs). The diameters of most tumor blood vessels are wide, and their shapes are curved in different sizes, with few pericytes around and defective BMs. Tumor blood vessels are also hyperpermeable. The tumor microenvironment consists of stromal cells, ECM components, and exosomes. Many growth factors that promote angiogenesis and their signaling pathways are involved in these changes. Multiple anti‐angiogenesis agents target different molecules. Drugs targeting immune checkpoints are also illustrated in this figure.