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Hijacking the vasculature in ccRCC—co-option, remodelling and angiogenesis

Nature Reviews Urology volume 10, pages 300–304 (2013)Cite this article

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Abstract

The most common type of malignancy in the adult kidney is clear cell renal cell carcinoma (ccRCC), for which antiangiogenic therapy with surgery is currently the standard treatment. Although overall survival of patients with metastatic ccRCC has been substantially extended by antiangiogenic therapy with agents such as sorafenib and sunitinib, patients almost certainly go on to develop resistance, or present at the time of treatment with primary resistance. This eventuality implies that our knowledge of the processes involved in tumour angiogenesis in ccRCC is superficial. Increasing evidence has shown that a solid tumour can, during invasion and expansion, 'hijack' pre-existing blood vessels and integrate them into the tumour vasculature. This approach to expanding the tumour vasculature is referred to as vessel co-option. In this Perspectives article, I argue that vessel co-option likely occurs in ccRCC, along with the complementary processes of vessel remodelling and extratumoural angiogenesis. Exploring the underlying molecular mechanisms of these complicated vasculature developments in ccRCC might provide new opportunities to enhance the efficacy of antiangiogenic therapy.

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Figure 1: Speculative vessel co-option of differentiated mature vessels in ccRCC.
Figure 2: High vessel density on the surface of ccRCC.

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Acknowledgements

The author is supported by grants from the National Natural Science Foundation of China (Grant No. 81030043 and 81272340), and the Van Andel Foundation. The author thanks Paul Elson, Quantitative Health Science (The Cleveland Clinic, OH) for statistical analyses and David Nadziejka (Grand Rapids, MI) for the critical reading of the manuscript.

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  1. State Key Laboratory on Oncology in South China, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, 510060, Guangdong, China

    Chao-Nan Qian

  2. Laboratory of Cancer and Developmental Cell Biology, Van Andel Research Institute, 333 Bostwick Avenue NE, Grand Rapids, 49503, MI, USA

    Chao-Nan Qian

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Qian, CN. Hijacking the vasculature in ccRCC—co-option, remodelling and angiogenesis. Nat Rev Urol 10, 300–304 (2013). https://doi.org/10.1038/nrurol.2013.26

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