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VEGF-A and VEGF-R1/2 Expression: Critical Importance in Different Stages of Human Gastric Adenocarcinoma

Christian Prinz

A key role for gastric micro vascularisation during cancer progression is the vascular growth factor VEGF-A. In gastric cancer, serum VEGF levels were also significantly higher in patients with advanced-stage cancer, higher lymph node ratio, and peritoneal invasion. Inhibition of VEGF or blockade of the corresponding VEGF-R1 and VEGF-R2 receptors has been investigated in the treatment of gastric adenocarcinoma. Treatment of VEGF-antibodies or VEGF-receptor antibodies, however, had no significant effect on overall survival. Most recently, however, a new and fully humanized IgG1 monoclonal antibody Ramucirumab (IMC-1121B) has been introduced, which targets the extracellular domain of VEGF receptor 2 (VEGFR2). The antibody, increasing the median overall survival compared to placebo. Thus, a more detailed analysis of VEGF and VEGF receptor expression in early compared to advanced stages is needed. The current review focuses on previous findings and describes own results in early compared to advanced stages of gastric adenocarcinoma. A special focus is given on VEGF-A expression as well as the expression of the corresponding receptors VEGF-R1 and VEGF-R2. Own data reveal that VEGF-R2 may be a better target since expression levels seem to be expressed at high levels in gastric cancer tissues