Anti-angiogenic therapy is currently one of most active fields in cancer research. The initial strategies, which were aimed at inhibiting tumor vascularization, included upregulation of endogenous inhibitors and blocking of the signals delivered by angiogenic factors. However, interactions between endothelial cells and their surrounding extracellular matrix also play a crucial role in modulation of the angiogenic process. Compounds that target either the integrins implicated in these interactions or the proteases responsible for matrix remodeling have been shown to halt tumor growth in murine models and are now in clinical trials. However, little attention has been paid to integrin ligands, the extracellular matrix components that support endothelial cell survival, movement and reorganization. Here, we summarize the current knowledge about these angiogenesis inhibitors and propose a novel therapeutic approach based on the blocking of crucial binding sites present in the extracellular matrix.

Sanz L, Alvarez-vallina L. The extracellular matrix: a new turn-of-the-screw for anti-angiogenic strategies. Trends Mol Med. 2003;9(6):256-62.