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Normalisation of surviving tumour vasculature maximises the efficacy of concomitant therapy

Avastin reduces interstitial fluid pressure in patients with rectal cancer⁶

Reprinted by permission from Macmillan Publishers Ltd: Willett, et al. Nat Med;10(2):145–7, copyright 2004.

• The unregulated nature of tumour angiogenesis leads to the production of structurally and functionally abnormal vasculature, characterised by a number of different features^11,12

  • increased vessel density, diameter, length and tortuosity

  • abnormally high interstitial fluid pressure

  • increased vascular permeability.

• These abnormalities prevent the effective delivery of therapy to the tumour^11,12

  • the entry of large molecules, such as chemotherapeutic agents, into the tumour is impeded

  • hypoxia results from inconsistent oxygen supply within the tumour, producing regions that are resistant to radiotherapy and some cytotoxic agents.

• Anti-angiogenic therapy, such as Avastin, normalises the tumour vasculature, pruning excess vessels and reducing interstitial fluid pressure and vessel permeability^11,12

  • this increases both the delivery of anticancer agents to the tumour and the sensitivity of tumour cells to those agents.