[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-382185-en":3,"doc-seo-382185-105":31,"detail-sidebar-cat-0-en-105":99},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":28,"seo_description":14,"update_tm":29,"read_time":30},382185,549758146520,"Patrick","https://ap-avatar.wpscdn.com/avatar/80002397d8c0411e94?_k=1775819394049821470",7,"Healthcare","Endostatin and Cancer Therapy: A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies","Angiogenesis is a physiological process forming new blood vessels and supporting growth, development, and wound healing, yet it also drives tumor growth and metastasis. The review focuses on VEGF, the main angiogenesis mediator, and the adverse limitations of anti-VEGF monoclonal antibodies such as bevacizumab. Endostatin, an endogenous inhibitor of VEGF expression and angiogenesis with a better safety profile, shows promising results in smaller clinical studies, motivating its use as an alternative.","biomedicines   \nReview  \nEndostatin and Cancer Therapy: A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies  \nGabriel M²ndez-Vald²s 1, Francisca Gâmez-Hevia 1, Jos² Lillo-Moya 1, Tommy Gonz¡lez-Fern¡ndez 1,  \nJoaquin Abelli 1, Antonia Cereceda-Cornejo 1, Maria Chiara Bragato 2, Luciano Saso 3 and Ramân Rodrigo 1, *  \nCitation: Méndez-Valdés, G.;  \nGómez-Hevia, F.; Lillo-Moya, J.; González-Fernández, T.; Abelli, J.; Cereceda-Cornejo, A.; Bragato, M.C.; Saso, L.; Rodrigo, R. Endostatin and Cancer Therapy: A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies. Biomedicines 2023, 11, 718. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/biomedicines11030718](10.3390/biomedicines11030718)  \nAcademic Editors: Matthew  \nR. Pincus and Wilbur B. Bowne  \nReceived: 1 February 2023  \nRevised: 19 February 2023  \nAccepted: 24 February 2023  \nPublished: 27 February 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago 8380000, Chile  \n2 Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy  \n3 Department of Physiology and Pharmacology “Vittorio Erspamer”, Faculty of Pharmacy and Medicine, Sapienza University, P.le Aldo Moro 5, 00185 Rome, Italy  \n* Correspondence: [rrodrigo@med.uchile.cl](rrodrigo@med.uchile.cl); Tel.: +56-229786126  \nAbstract: Angiogenesis is a physiological process that consists of the formation of new blood vessels from preexisting ones. Angiogenesis helps in growth, development, and wound healing through the formation of granulation tissue. However, this physiological process has also been linked to tumor growth and metastasis formation. Indeed, angiogenesis has to be considered as a fundamental step to the evolution of benign tumors into malignant neoplasms. The main mediator of angiogenesis is vascular endothelial growth factor (VEGF), which is overexpressed in certain cancers. Thus, there are anti-VEGF monoclonal antibodies, such as bevacizumab, used as anti-cancer therapies. However, bevacizumab has shown adverse events, such as hypertension and proteinuria, which in the most severe cases can lead to cessation of therapy, thus contributing to worsening patients' prognosis. On the other hand, endostatin is an endogenous protein that strongly inhibits VEGF expression and angiogenesis and shows a better safety profile. Moreover, endostatin has already given promising results on small scale clinical studies. Hence, in this review, we present data supporting the use of endostatin as a replacement for anti-VEGF monoclonal antibodies.  \nKeywords: endostatin; angiogenesis; anti-cancer peptides  \n1. Introduction  \nCancer is one of the leading causes of death worldwide, being responsible for almost 10 million deaths in 2020, according to the World Health Organization (WHO), and with about 18 million new cases diagnosed every year [1] . This is one of the major public health problems in most countries around the world, being both a burden on health and economics. Surgery can offer a total cure if the cancer is diagnosed at an early stage, however, regrettably most cancers are recognized when they are already locally advanced or with distant metastases, and in these cases, surgery alone does not provide an adequate treatment.  \nIn this scenario, the first line of treatment is chemotherapy. Chemotherapy can also be associated with radiotherapy [2], being more effective in improving the survival of cancer patients. Woefully, this therapy is accompanied by a wide variety of adverse effects that often result in discontinuation of it [2]","cbCaiuAYsmXJpfuv","https://ap.wps.com/l/cbCaiuAYsmXJpfuv","pdf",4578866,10,1,23,"English","en",105,"# Abstract\n# Introduction\n# Angiogenesis","[{\"question\":\"Why is angiogenesis important in cancer progression?\",\"answer\":\"Angiogenesis supports the evolution of benign tumors into malignant neoplasms and facilitates metastasis formation by supplying growing tissues with blood supply.\"},{\"question\":\"What safety issues are associated with anti-VEGF monoclonal antibodies such as bevacizumab?\",\"answer\":\"Bevacizumab can cause adverse events including hypertension and proteinuria, which in severe cases may lead to stopping therapy and worsen patient prognosis.\"},{\"question\":\"How does endostatin differ from anti-VEGF monoclonal antibodies as a therapeutic option?\",\"answer\":\"Endostatin is an endogenous protein that strongly inhibits VEGF expression and angiogenesis, with a better safety profile and promising results from small-scale clinical studies, supporting its potential replacement role.\"}]","Endostatin and Cancer Therapy: A Novel Potential Alternative to Anti-VEGF Monoclonal Antibodies | 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is angiogenesis important in cancer progression?","Question",{"text":82,"@type":83},"Angiogenesis supports the evolution of benign tumors into malignant neoplasms and facilitates metastasis formation by supplying growing tissues with blood supply.","Answer",{"name":85,"@type":80,"acceptedAnswer":86},"What safety issues are associated with anti-VEGF monoclonal antibodies such as bevacizumab?",{"text":87,"@type":83},"Bevacizumab can cause adverse events including hypertension and proteinuria, which in severe cases may lead to stopping therapy and worsen patient prognosis.",{"name":89,"@type":80,"acceptedAnswer":90},"How does endostatin differ from anti-VEGF monoclonal antibodies as a therapeutic option?",{"text":91,"@type":83},"Endostatin is an endogenous protein that strongly inhibits VEGF expression and angiogenesis, with a better safety profile and promising results from small-scale clinical studies, supporting its potential replacement 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