The role of angiogenesis inhibitors in prostate cancer.

Prostate cancer is the leading noncutaneous malignancy in American men. Only the combination of docetaxel and prednisone has been shown to improve survival in patients with metastatic castrate-resistant prostate cancer. However, responses are short and a search for better agents either alone or synergistic with chemotherapy continues to be an urgent medical need. Angiogenesis has been shown to be a prerequisite event for tumor growth and metastasis in prostate cancer. Several strategies have been used to target angiogenesis in prostate cancer. These include blocking of pro-angiogenic factors via monoclonal antibodies or small molecule inhibitors targeting downstream signaling effector pathways, direct inhibition of endothelial cells, or targeting other receptors involved in cell adhesion, proliferation, and survival. Agents such as thalidomide and bevacizumab have shown encouraging results in phase II trials, and this review focuses on the clinical trials that have used these agents and other novel agents. The use of angiogenesis inhibitors is rapidly emerging as a promising treatment strategy in a variety of solid tumors, currently including prostate cancer.