Hypoxia, angiogenesis, and lung cancer.

Lung cancer is responsible for more deaths than any other cancer in America. As a result, novel ways to treat it are needed to improve patient outcomes. A tumor must form new blood vessels to grow and metastasize to distant sites; this angiogenesis is mediated by factors such as vascular endothelial growth factor (VEGF). Because it increases VEGF levels, hypoxia has been thought to be a primary trigger of angiogenesis. Tumor hypoxia and higher levels of serum markers of angiogenesis have been associated with poor prognosis in non-small cell lung cancer (NSCLC). In recent years, antiangiogenic compounds have been developed and tested in various solid malignancies, including NSCLC, for which bevacizumab, a monoclonal antibody against VEGF, was recently approved. Combinations of antiangiogenic drugs and conventional cytotoxic chemotherapy are currently under development.