Angiogenesis inhibitors in the management of breast cancer.

PURPOSE OF REVIEW: An improved understanding of the important role of angiogenesis in tumor biology has led to development of different antiangiogenic therapies. This review highlights therapeutic agents from recent breast cancer trials showing the greatest potential for further clinical use in the near future. RECENT FINDINGS: Numerous clinical studies for several antiangiogenic agents have recently been conducted in breast cancer patients and different antiangiogenic approaches have demonstrated their antitumor activity. Bevacizumab is the most advanced agent, being the first approved angiogenesis inhibitor in metastatic breast cancer. The multikinase inhibitors sorafenib, sunitinib, and pazopanib have also shown promising early results and are further evaluated. To maximize efficacy and safety of antiangiogenic agents and help selecting patients suitable for this therapy, identification of predictive biomarkers is essential. SUMMARY: Novel antiangiogenic agents have produced positive data in clinical trials for breast cancer leading to the approval of bevacizumab for the first-line therapy of metastatic breast cancer. Other interesting substances such as multikinase inhibitors are currently being investigated. So far, angiogenesis inhibitors provide an additional therapeutic option for metastatic breast cancer; their role in early breast cancer as well as optimal patient selection will need further research.