The growth and spread of neoplasms depends on the establishment of an adequ
ate blood supply; that is, angiogenesis. The onset of angiogenesis involves
a change in the local equilibrium between proangiogenic and antiangiogenic
regulators that are produced by tumor cells, surrounding stromal cells, an
d infiltrating leukocytes. In most normal tissues, factors that inhibit ang
iogenesis predominate, whereas in rapidly dividing tissues, the balance of
angiogenic molecules favors stimulation of the process. A potent inhibitor
of angiogenesis is interferon-alpha or -beta, shown to down-regulate transc
ription and protein production of basic fibroblast growth factor, collagena
se type IV, and interleukin-8. The daily systemic administration of low (bu
t not high) dose of interferon-alpha can produce significant inhibition of
angiogenesis and, hence, regression of human tumors implanted orthotopicall
y in nude mice. The recent elucidation of the interaction among proangiogen
ic molecules during physiological processes and the apparent disruption of
this balance in neoplasia should allow the design of potent and antiangioge
nic therapies against primary cancers and metastases.