Antiangiogenic agents should be integrated into the standard treatment for patients with ovarian cancer.

Tumor angiogenesis is a fundamental process driving the progression of epithelial ovarian cancer and related malignancies. The question is whether agents targeting tumor angiogenesis should at this time be integrated into standard treatment. In this article, the pro side of this question is presented. Multiple phase II trials have demonstrated efficacy for antiangiogenic agents in the treatment of women with recurrent ovarian cancer. Results of three phase III trials evaluating the antivascular endothelial growth factor antibody bevacizumab have been presented, all demonstrating significant increases in progression-free survival when combined with standard cytotoxic chemotherapy and continued beyond chemotherapy, with acceptable toxicity. Several other angiogenesis-targeted agents are undergoing phase III evaluation. Based on these data, it is concluded that antiangiogenic therapy, at least with bevacizumab, should be integrated into the standard clinical management of patients with this disease. Further investigation is needed to determine optimal utilization.