Endostatin and Cancer Therapy: A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies

Angiogenesis is a physiological process that consists of the formation of new blood vessels from preexisting ones. Angiogenesis helps in growth, development, and wound healing through the formation of granulation tissue. However, this physiological process has also been linked to tumor growth and metastasis formation. Indeed, angiogenesis has to be considered as a fundamental step to the evolution of benign tumors into malignant neoplasms. The main mediator of angiogenesis is vascular endothelial growth factor (VEGF), which is overexpressed in certain cancers. Thus, there are anti-VEGF monoclonal antibodies, such as bevacizumab, used as anti-cancer therapies. However, bevacizumab has shown adverse events, such as hypertension and proteinuria, which in the most severe cases can lead to cessation of therapy, thus contributing to worsening patients' prognosis. On the other hand, endostatin is an endogenous protein that strongly inhibits VEGF expression and angiogenesis and shows a better safety profile. Moreover, endostatin has already given promising results on small scale clinical studies. Hence, in this review, we present data supporting the use of endostatin as a replacement for anti-VEGF monoclonal antibodies.

Automated summary

Angiogenesis is a process involving the formation of new blood vessels from preexisting ones, which plays important roles in physiological processes and tumor growth. Vascular endothelial growth factor (VEGF) is the main mediator of angiogenesis and is overexpressed in certain cancers, leading to the development of anti-VEGF monoclonal antibodies as cancer therapies. However, these antibodies have shown adverse events, while endostatin, an endogenous protein that inhibits VEGF expression and angiogenesis, has a better safety profile and promising results on small scale clinical studies. Therefore, endostatin is proposed as a replacement for anti-VEGF monoclonal antibodies.