Targeting Angiogenesis: New Horizons in Ocular Tumor Therapy

Angiogenesis, the formation of new blood vessels within malignant tumors, is essential for cancer growth, sustenance, and metastasis. This complex process is regulated by a variety of molecular factors and pathways, as explored in a recent comprehensive review on angiogenesis. The review highlights the regulatory mechanisms that unlock therapeutic potential, focusing on hypoxia and its role in inducing vascular endothelial growth factor (VEGF) expression, a key driver of angiogenesis. It examines the interplay between angiopoietins, fibroblast growth factors (FGFs), and endogenous inhibitors of angiogenesis, as well as the role of transmembrane adhesion proteins, such as integrins, in mediating cellular responses critical to vascular development. The review also discusses the critical role of angiogenesis in tumor growth, emphasizing how the "angiogenic switch" enables tumors to acquire an aggressive phenotype. In this context, anti-angiogenic (AAG) therapies targeting these pathways are being investigated for various cancers, including ocular malignancies. Despite the widespread use of angiogenesis inhibitors in non-malignant ocular diseases, reports of their application in ocular tumors remain limited. Evidence supports the involvement of angiogenesis in the progression and metastasis of ocular malignancies, including retinoblastoma, ocular melanoma, and Von Hippel-Lindau (VHL) disease. Preliminary studies of AAG therapies for ocular tumors, such as ocular melanoma and VHL, show promising results. However, their efficacy needs to be confirmed through well-designed, controlled clinical trials. By providing a detailed overview of the molecular underpinnings of angiogenesis and its implications for tumor growth, this review underscores the potential of targeting angiogenic pathways as a therapeutic strategy for ocular tumors and other malignancies.