ADVANCES IN ANGIOGENESIS RESEARCH - RELEVANCE TO UROLOGICAL ONCOLOGY

Purpose: Important advances in angiogenesis research are reviewed alon g with recent data implicating angiogenesis in the pathogenesis of uro logical malignancies. Materials and Methods: The current understanding of angiogenesis and its importance in tumor biology is summarized. Th e rationale for anti-angiogenic therapy is reviewed and the clinical e xperience with these agents is discussed. An extensive literature sear ch of angiogenesis in urological malignancies was performed. Results: Quantitative immunohistochemistry for endothelial antigens suggests th at, as is the case with many other tumors, induction of angiogenesis c ontributes to the malignant phenotype of prostate and bladder carcinom as. Anti-angiogenic agents have demonstrated efficacy against urologic al tumors in experimental systems, and recent data suggest that these agents may also be useful for chemoprophylactic purposes. Putative ang iogenesis inducers specific for each of the major urological malignanc ies have been identified. Quantitation of the expression of angiogenes is inducers and estimation of microvessel density have demonstrated pr ognostic value for urological malignancies. Conclusions: The available data indicate that angiogenesis has an important role in the progress ion and metastasis of urological malignancies. Preclinical data couple d with experience in other cancers indicate that combining anti-angiog enic therapy with conventional treatment modalities has the potential to improve dramatically our management of these malignancies. Further research will be needed to define the mechanisms controlling angiogene sis in urological malignancies and to determine if any of the angiogen ic correlates will be of genuine clinical use. The rapid pace of resea rch in this field suggests that this aspect of tumor biology will soon have an increasingly important role in the evaluation and treatment o f urological cancers.