ANTIANGIOGENIC THERAPY AND VEGF-VEGFR SYSTEM IN RENAL-CELL CANCER

Special interest to the problem of angiogenesis in renal cancer is imposed by the fact that a key role in the etiology and pathogenesis of this disease, especially of its clear-cell variant, belongs to inactivating mutation in tumor-suppressor gene VHL which is tightly associated with hypoxia-induced factor HIF-1α and activation of angiogenesis. Renal cancer is one of the few diseases where preparations inhibiting tyrosine kinase activity of VEGF and some other proangigenic factors’ receptors are successfully applied. However, despite the noteworthy achievements of this therapy many questions related to the prediction of its efficiency remain unsolved. On the other hand, results of clinical laboratory investigations demonstrate unfavorable prognostic role of high VEGF expression in renal cancer tissue independently of the type of treatment applied, while the published data concerning the clinical value of VEGF and its receptors’ levels in physiological body fluids of renal cancer patients are rather scarce and controversial. In this review key publications devoted to the possible implications of angiogenesis markers in diagnostics, prognosis, prediction of sensitivity to antiangiogenic treatment and monitoring of its efficiency in renal cancer patients. In addition, the data on modern targeted drugs, approaches and prospects of antiangiogenic therapy of this disease are summarized.