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Yull E. Arriaga

and Arthur E. Frankel

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date: 09 July 2020

Angiogenesis, the process of vessel growth from preexistent blood vessels, is a necessary step in tumour growth and metastasis. The tumour angiogenic process is complex and involves multiple cells including tumour cells, endothelial tip and stalk and phalanx cells, mural pericytes–smooth muscle cells–fibroblasts,and recruited macrophages–neutrophils–marrow progenitors. The molecular signals among these cell participants lead sequentially to breakdown of the extracellular matrix, loosening of endothelial adhesions, invasion of tip cells towards the tumour, proliferation of stalk cells, fusion of neighbouring branches, lumen formation, phalanx quiescence, engagement of pericytes, and maturation of a new extracellular matrix. Multiple, redundant, and interactive molecules achieve each milestone. Therapeutics aimed at inhibiting or modifying tumour angiogenesis have reached clinical practice with modest benefit. Application of knowledge of the biologic and biochemical processes should yield predictive biomarkers and improved antitumour angiogenesis regimens in the near future.

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