Book Review

Angiogenesis: From Basic Science to Clinical Applications

N Engl J Med 2007; 356:2226-2227May 24, 2007

Article

Angiogenesis: From Basic Science to Clinical Applications
Edited by Napoleone Ferrara. 280 pp., illustrated. Boca Raton, FL, CRC Press, 2007. $149.95. ISBN: 978-0-8493-2844-2

In 1989, two consecutive reports in Science described the cloning of vascular endothelial growth factor (VEGF) (the protein originally identified by Harold Dvorak and colleagues as vascular permeability factor), a landmark in the field of angiogenesis. Subsequent studies and clinical trials have since confirmed that VEGF is the dominant angiogenic factor in numerous diseases. Furthermore, numerous recent clinical trials have shown that the inhibition of VEGF can benefit patients with a variety of diseases in which angiogenesis has a role. Napoleone Ferrara, the editor of Angiogenesis, was an author of one of the 1989 reports in Science; his laboratory not only cloned the VEGF gene but also developed the anti–VEGF monoclonal antibodies bevacizumab and ranibizumab, now approved by the Food and Drug Administration (FDA) for the treatment of malignant and ocular diseases, respectively.

Angiogenesis is a thorough overview of the basic science of the field, with an appropriate focus on VEGF biology. In addition to containing comprehensive discussions of VEGF biology and its role in angiogenesis and lymphangiogenesis, the book includes several chapters on the role of VEGF in processes other than angiogenesis, including the effects of VEGF on the nervous system. The book is predominantly devoted to the VEGF signaling pathway — an appropriate choice, as proangiogenic and antiangiogenic approaches in clinical medicine are based almost entirely on aberrations of VEGF signaling.

Confocal Micrograph of a Blood Vessel Branching into the Retinal Capillary Bed.

The strength of the book lies in the expertise and insights of the contributors, who have all made important contributions to the field, including work on the cloning and characterization of numerous angiogenic mediators. The chapters are brief and include clear, easily comprehensible figures that would make excellent slides for lectures on the basic biology of angiogenesis. Several color plates, grouped in the middle of the book, replicate important black-and-white figures from various chapters.

Ferrara clearly states in the preface that Angiogenesis is not a comprehensive overview of the field. However, because the fields of basic science and clinical medicine are merging, an expanded discussion on anti-VEGF therapy for malignant diseases would have been beneficial. The single chapter addressing anti-VEGF therapy in patients with cancer is limited to the use of bevacizumab, and most of the discussion focuses on studies in colorectal cancer. Although most clinical studies are in this area, it is important to point out that tyrosine kinase inhibitors that target VEGF receptors have been shown to be effective and are approved by the FDA for the treatment of renal-cell carcinoma.

Overall, Angiogenesis is an outstanding overview of the topic in general and of VEGF biology in particular. Clinicians will want to complement the book's content by reading recent print and online reviews for more up-to-date results from clinical trials in cancer, ocular diseases, and cardiovascular diseases. Because the outcomes of ongoing clinical trials may have an immediate effect on the care of patients, clinicians must stay apprised of real-time changes in the field by seeking various sources for updates of clinical trial results and FDA approvals.

Lee M. Ellis, M.D.
University of Texas M.D. Anderson Cancer Center, Houston, TX 77230