At least initially, these agents probably will be used as an adjunct to radiotherapy, chemotherapy, interferon, and other antitumor therapies. Erlichman has proposed that inhibitors be administered after removal of a primary tumor when there is a high risk for recurrence, or after a tumor has spread and other adjunctive measures are impractical. Folkman's general impression from early trials presented at meetings in the United States and Europe was that these inhibitors cause disease to stabilize or even regress slowly in some patients. Angiogenesis inhibitors may also be useful for treating blinding eye diseases caused by neovascularization, skin conditions such as psoriasis, life-threatening hemangiomas, and refractory gastrointestinal ulcers. Inhibitors must be avoided in postoperative patients.
Inhibitors are hazardous during pregnancy.
Thalidomide certainly has teratogenic effects, and some other angiogenesis inhibitors are abortifacients. The angiostatins, however, do not seem to adversely affect pregnancy or the fetus. It has many principles in it that affect other aspects of medical practice. That this potential has not been realized reflects the fact that, in the context of what is yet to come, this work is still at a preliminary stage. Suggested Reading Boehm T, Folkman J, Browder J, O'Reilly M. Antiangiogenic therapy of experimental cancer does not induce acquired drug resistance.