Adverse Effect Management for Vascular Endothelial Growth Factor-Targeted Agents (Feature Article) (Clinical Report‪)‬

Introduction In the 1960s, Dr Judah Folkman observed that tumours could not grow larger than the head of a pin in the absence of blood vessels. He first published his hypothesis that all malignant tumour growth is angiogenesis dependent, introducing the concept of 'anti-angiogenesis' as a potential novel anti-cancer therapy [1]. In 2003, the first monoclonal antibody, bevacizumab (avastin), which predominantly binds to the vascular endothelial growth factor (VEGF)-A isoform [2] became the first anti-angiogenic drug shown in large-scale clinical trials to prolong survival in cancer patients. We are now aware of the complexity of the VEGF pathway and the prospect this brings of developing broader-spectrum inhibitors for greater efficacy.