Epithelial ovarian cancer has the highest mortality rate of all gynaecological malignancies. Most women present with advanced disease and develop a recurrence after radical surgery and chemotherapy. Ovarian cancer is a heterogeneous disease with complex molecular and genetic changes.In EOC, angiogenesis plays a role in tumour growth, formation of ascites and metastasis. Key angiogenic molecules include vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), fibroblast growth factor (FGF) and angiopoietin (Ang 1 and 2). The Ang 1/2eTie 2 receptor axis is a VEGF-independent signalling pathway that mediates vascular remodeling.The endothelial cells within these vessels are more dependent on VEGF for survival than more mature blood vessels elsewhere in the body.Inhibition of VEGF restores the balance between pro-angiogenic and anti-angiogenic factors,thereby normalising tumour blood vessel structure and function.Tyrosine kinase inhibitors are multi-targeted, low-molecular-weight drugs that bind to the ATPbinding catalytic site of the tyrosine kinase domains of VEGF-R and other tyrosine kinases.

References

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