Learning from Angiogenesis Trial Failures

Although targeting angiogenesis is a promising anticancer approach, the recent spate of Phase III trial failures has bashed some scientists' hopes for success. According to industry insiders, however, the 12 recent failures involving five trials are symptoms of a young field, of clinical trial design that requires unconventional endpoints, and of improper delivery systems, rather than a condemnation of the general approach. Moreover, because drug development takes such a long time, researchers h

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"About 40 papers a week are coming out [on angiogenesis]; it is a very fast-moving field," says Judah Folkman, professor of pediatric surgery and cell biology at Children's Hospital in Boston. "Ten years ago, people thought all new capillaries were the same, but now we know they're not."

According to Laura Shawver, president of Sugen, the company that initially developed SU5416 and was later acquired by Pharmacia, "[Angiogenesis] wasn't studied from the drug development perspective until the '90s." SU5416 targets the vascular endothelial growth factor (VEGF) receptor. When VEGF was discovered in 1989, it was the first factor known to be specifically involved in the proliferation and migration of blood vessel precursor cells. Subsequently, labs began focusing on VEGF inhibition. However, at that time, it was less understood that as tumors progress, they express an increasingly broad array of pro-angiogenic growth factors. "In the first generation of angiogenesis inhibitors that ...

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