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Review
. 2024 Mar 5;16(5):1063.
doi: 10.3390/cancers16051063.

The Potential Influence of Residual or Recurrent Disease on Bevacizumab Treatment Efficacy in Ovarian Cancer: Current Evidence and Future Perspectives

Klaudia Żak  1 , Małgorzata Satora  2 , Ilona Skrabalak  3 , Rafał Tarkowski  3 , Marta Ostrowska-Leśko  4 , Marcin Bobiński  3
Affiliations
Review

The Potential Influence of Residual or Recurrent Disease on Bevacizumab Treatment Efficacy in Ovarian Cancer: Current Evidence and Future Perspectives

Klaudia Żak et al. Cancers (Basel). .

Abstract

There were high hopes for the new antiangiogenic medicament, bevacizumab, which could inhibit the creation of new blood vessels through binding to isoform A of vascular endothelial growth factor (VEGF). However, it is not only blood vessels that are responsible for tumor cell spread. During the process of tumor growth, lymphangiogenesis is mediated by other members of the VEGF family, specifically VEGF-C and VEGF-D, which act independent to bevacizumab. Therefore, based on the mechanism of bevacizumab action and the processes of angio- and lymphangiogenesis, we formed three hypotheses: (1) if the lymph nodes in primary ovarian cancers are metastatic, the outcome of bevacizumab treatment is worsened; (2) concerning the second-line treatment, bevacizumab will act in a weakened manner if recurrence occurs in lymph nodes as opposed to a local recurrence; (3) patients treated by bevacizumab are more likely to have recurrences in lymph nodes. These hypotheses raise the issue of the existing knowledge gap, which concerns the effect of bevacizumab on metastatic lymph nodes.

Keywords: VEGF; angiogenesis; bevacizumab; ovarian cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Vascular endothelial growth factor (VEGF) family members impact on tumor microenvironment. (ECM—extracellular matrix, IFP—interstitial fluid pressure, PIGF—placenta growth factor, TME—tumor microenvironment, and VEGFR—vascular endothelial growth factor receptor.)
Figure 2
Figure 2
Factors involved in (A) lymphangiogenesis and (B) angiogenesis. (A) In the process of lymphangiogenesis, VEGF-C and VEGF-D play a key role, in addition, other factors influence the process of lymphangiogenesis. (B) In the process of angiogenesis, VEGF is one of the most well-studied growth factors; however, other factors, such as FGF, PDGF, Ang, HGF, IGF, and TNFα also play an essential role. (VEGF-C—vascular endothelial growth factor C, VEGF-D—vascular endothelial growth factor D, FGF—fibroblast growth factor, PDGF-platelet-derived growth factor, Ang—angiopoietin 1, HGF—hepatocyte growth factor, IGF—insulin-like growth factor, and TNFα—tumor necrosis factor α).
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