Proposed MoA of anti-VEGF agents
Based on preclinical models and clinical observations, it has been proposed that anti-VEGF agents exert continuous anti-angiogenic effects throughout tumour development. One of the most rapid of these proposed effects is regression of existing tumour vessels. Direct and rapid changes observed with anti-VEGF agents include a significant reduction in microvascular density.8,11–13
While some aberrant tumour microvasculature may be regressed,11 other surviving mature vasculature may become normalised.8,14 This reversal of structural and functional abnormalities may improve the vasculature's capacity for drug delivery.15,16 In addition to these more rapid effects, anti-VEGF agents may also result in ongoing inhibition of both new and recurrent tumour vessel growth.9,10,13 It has been proposed that these effects inhibit tumour growth and metastasis and improve the tumour vasculature's capacity for effective delivery of antitumour compounds.14–17
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