The multifaceted world of angiogenesis control

Because of its key role in tumor growth, angiogenesis has become an attractive target for pharmacological therapies. The angiogenic process is regulated by several "classic" factors among which the most studied are VEGF and fibroblast growth factor-2 (FGF-2). These factors together with their receptors and other molecules involved in their signaling pathways are currently the main target of an extensive array of pharmacological strategies aimed at inhibit angiogenesis. In recent years, however, evidence has accumulated that in addition to the classic factors many other endogenous peptides play an important regulatory role in angiogenesis, especially under pathological conditions. Such a large network of signaling events might offer new possibilities of pharmacological intervention that could be complementary to existing antiangiogenic treatments. In particular, combination therapies could be devised to overcome or delay resistance and minimize side effects. In the last issue of Expert Opinion on Therapeutic Targets, in a paper by Deville et al., the authors focussed their attention on these important topics, and in this context offered a thoughtful analysis about the possible place of the peptide adrenomedullin as a new therapeutic target in future antiangiogenic strategies.