Clinical significance of vascular endothelial growth factor expression in gastric cancer

Vascular endothelial growth factor (VEGF) is an angiogenic factor in human cancer tissue. To clarify the clinical significance of this factor, we investigated the VEGF expression in early and advanced gastric cancer. This study included analysis of data on 243 patients with gastric cancer, including 118 in the early stage and 125 in the advanced stage. VEGF was immunohistochemically stained. Of 243 tumors, 102 (42%) were VEGF-positive. The VEGF-positive gastric cancers were larger, more invasive, and classified in the more advanced stage than VEGF negative ones. Patients with VEGF-positive cancers had significantly lower survival rates than did those with negative ones, both in early and advanced stages (P < 0.05, P < 0.01, respectively). The VEGF-positive isolates had more hematogenous metastases than VEGF-negative ones. Multivariate analysis revealed VEGF to be an independent prognostic factor and independent risk factor for liver metastasis. The VEGF expression in cancer cells can serve as a pertinent prognostic indicator both in early and advanced gastric cancer.     

Clinical significance of vascular endothelial growth factor-C and vascular endothelial growth factor receptor 3 in patients with T1 lung adenocarcinoma

BACKGROUND: Vascular endothelial growth factor-C (VEGF-C) plays an important role in lymphangiogenesis and activates VEGF receptor-3 (VEGFR-3). Lymphatic spread is an important prognostic factor in patients with lung adenocarcinoma. The aim of the current study was to determine whether the expression of VEGF-C and VEGFR-3 correlates with clinicopathologic factors and prognosis in patients with TNM classification T1 lung adenocarcinoma. METHODS: The authors conducted a retrospective review of 129 consecutive patients who underwent complete resection for T1 lung adenocarcinoma. Immunohistochemical staining for VEGF-C, VEGF, VEGFR-3, CD34 (microvessels), tryptase (mast cells), and CD68 (macrophages) was performed to statistically analyze clinicopathologic implications of VEGF-C and VEGFR-3 status. RESULTS: Of 129 patients with T1 lung adenocarcinoma, 56 (43.3%) patients were positive for tumor-cell VEGF-C and 73 (56.6%) and 69 (53.5%) patients were positive for tumor-cell and endothelial-cell VEGFR-3, respectively. Patients with positive staining for tumor-cell VEGF-C showed significantly less favorable survival rates than patients with negative staining (P = 0.031). The survival rates of patients with positive staining for tumor-cell and endothelial-cell VEGFR-3 were significantly lower than those with negative staining (P = 0.0034 and P = 0.0020, respectively). Patients with positive staining for both tumor-cell VEGF-C and endothelial-cell VEGFR-3 exhibited the most unfavorable prognoses. Multivariate analysis demonstrated that coexpression of tumor-cell VEGF-C and endothelial-cell VEGFR-3 was an independent negative prognostic factor (P = 0.0129) as well as N factor (P = 0.0020). CONCLUSIONS: VEGF-C and VEGFR-3 status may be indicative of survival rates for patients with T1 lung adenocarcinoma.     

胃癌组织中环氧化酶-2的表达与微血管密度和VEGF的关系

目的 :探讨环氧化酶 -2 (COX 2 )在胃癌组织中的表达及其与微血管密度(microvesseldensity ,MVD)和血管内皮生长因子 (vascularendothelial growthfactor ,VEGF)的关系。方法 :采用免疫组织化学法 ,检测 43例胃癌患者手术切除标本中COX 2和VEGF的表达 ,并计数MVD。结果 :COX 2在胃癌组织的阳性表达率为60 5 % ,明显高于对照组 ,P <0 0 1;并且与胃癌淋巴结的转移和临床分期有关 ,与肿瘤大小、浸润深度、分化程度均无关。COX 2和VEGF表达一致符合率为 5 3 5 % ,两者表达有显著相关性 ,P <0 0 1。COX 2阳性和VEGF阳性组MVD值 (2 2 0 8± 3 69、2 2 12± 3 5 0 )均高于COX 2阴性和VEGF阴性组 (17 68± 3 5 0、16 15± 3 2 3 ) ,P <0 0 5 ;COX 2和VEGF均为阳性者的MVD值最高 (2 2 86± 3 40 ) ,P <0 .0 5。结论 :COX 2、VEGF的表达以及MVD的测定可作为判断胃癌恶性潜能的重要生物指标。COX 2、VEGF的表达对肿瘤血管形成可能起重要作用 ,联合检测COX 2、VEGF的表达对了解肿瘤血管形成的机制有一定的作用     

VEGF及其受体与胃癌的关系

VEGF是新生血管形成的主要促进因子,胃癌细胞的生长及转移与VEGF的产生及VEGFR的特异性激活密切相关.现综述近年来有关VEGF、VEGFR与胃癌关系,以及VEGF、VEGFR抑制剂在胃癌治疗中应用的研究进展.     

Clinical significance of vascular endothelial growth factor C and vascular endothelial growth factor receptor 3 in patients with nonsmall cell lung carcinoma

BACKGROUND: Vascular endothelial growth factor C (VEGF-C) plays an important role in lymphangiogenesis and activates VEGF receptor 3 (VEGFR-3). By contrast, lymphatic spread is an important prognostic factor in patients with nonsmall cell lung carcinoma (NSCLC). The objective of the current study was to determine whether the expression of VEGF-C and VEGFR-3 correlates with clinicopathologic factors and prognosis in patients with primary NSCLC. METHODS: The authors conducted a retrospective review of 180 consecutive patients who underwent complete resection for NSCLC and who did not receive any chemotherapy or radiotherapy prior to surgery. Immunohistochemical staining for VEGF-C and VEGFR-3 was performed. The clinicopathologic implications of VEGF-C and VEGFR-3 expression were analyzed statistically. RESULTS: Of 180 patients with NSCLC, 137 patients (76.1%) were positive for VEGF-C, and 40 patients (22.2%) were positive for VEGFR-3. VEGF-C expression was observed frequently in patients with adenocarcinoma (P = 0.026). For VEGFR-3 expression, significant correlations were demonstrated with age (P = 0.02), gender (P = 0.008), and histologic differentiation in patients with squamous cell carcinoma (P = 0.03). Patients who had positive staining for VEGF-C showed significantly less favorable survival rates compared with patients who had negative staining for VEGF-C (P = 0.003). The survival rates of patients who had positive staining for VEGFR-3 also were significantly lower compared with patients who had negative staining for VEGFR-3 (P < 0.001). Patients who had positive staining for both VEGF-C and VEGFR-3 exhibited the most unfavorable prognoses. Univariate analysis revealed the following prognostic factors: gender (P = 0.03), tumor status (T1,T2 vs. T3; P < 0.01), lymph node status (negative vs. positive; P < 0.01), tumor size (< or = 35 mm vs. > 35 mm; P < 0.01), disease stage (Stage I vs. Stages II and III; P < 0.01), VEGF-C expression (negative vs. positive; P < 0.01), VEGFR-3 expression (negative vs. positive; P < 0.01) and combined VEGF-C and/or VEGFR-3 expression (both positive vs. VEGF-C or VEGFR-3 positive; P < 0.01). Multivariate analysis demonstrated that VEGFR-3 expression was the only independent negative prognostic factor (P < 0.01). CONCLUSIONS: VEGF-C and VEGFR-3 expression may be indicative of survival rates for patients with NSCLC.     

Tumor-specific expression of vascular endothelial growth factor receptor 2 but not vascular endothelial growth factor or human epidermal growth factor receptor 2 is associated with impaired response to adjuvant tamoxifen in premenopausal breast cancer.

PURPOSE: Vascular endothelial growth factor A (VEGF-A) and vascular endothelial growth factor receptor 2 (VEGFR2) are often coexpressed in breast cancer, and potentially affect cellular pathways and key proteins such as the estrogen receptor (ER) targeted by endocrine treatment. We therefore explored the association between adjuvant tamoxifen treatment in breast cancer and expression of VEGF-A and VEGFR2, as well as human epidermal growth factor receptor 2 (HER2), which represents a candidate gene product involved in tamoxifen resistance. PATIENTS AND METHODS: Immunohistochemical expression of tumor-specific VEGF-A, VEGFR2, and HER2 was evaluated in tumor specimens from premenopausal breast cancer patients randomly assigned to 2 years of tamoxifen or no treatment (n = 564), with 14 years of follow-up. Hormone receptor status was determined in 96% of the tumors. RESULTS: VEGF-A, VEGFR2, and HER2 were assessable in 460, 472, and 428 of the tumors, respectively. In patients with ER-positive and VEGFR2-low tumors, adjuvant tamoxifen significantly increased recurrence-free survival (RFS; [HR] hazard ratio for RFS, 0.53; P = .001). In contrast, tamoxifen treatment had no effect in patients with VEGFR2-high tumors (HR for RFS, 2.44; P = .2). When multivariate interaction analyses were used, this difference in treatment efficacy relative to VEGFR2 expression status was statistically significant for both ER-positive (P = .04) plus ER-positive and progesterone receptor-positive tumors. We found no significant difference in tamoxifen treatment effects in relation to VEGF-A or HER2 status. CONCLUSION: Tumor-specific expression of VEGFR2 was associated with an impaired tamoxifen effect in hormone receptor-positive premenopausal breast cancer. Tamoxifen in combination with VEGFR2 inhibitors might be a novel treatment approach for VEGFR2-expressing breast cancer, and such a treatment might restore the tamoxifen response.     

RUNX3 inhibits the expression of vascular endothelial growth factor and reduces the angiogenesis, growth, and metastasis of human gastric cancer.

PURPOSE: Recent studies indicated that RUNX3 exhibits potent antitumor activity. However, the underlying molecular mechanisms of this activity remain unclear. In the present study, we used a gastric cancer model to determine the effect of RUNX3 expression on tumor angiogenesis. EXPERIMENTAL DESIGN: The effects of increased RUNX3 expression on vascular endothelial growth factor (VEGF) expression in and angiogenic potential of human gastric cancer cells were determined in vitro and in animal models. RUNX3 and VEGF expression was determined in 120 human gastric cancer specimens and their relationship was analyzed. RESULTS: RUNX3 gene transfer suppressed VEGF expression in human gastric cancer cells. Down-regulation of VEGF expression correlated with a significantly impaired angiogenic potential of human gastric cancer cells. Furthermore, RUNX3 restoration inhibited tumor growth and metastasis in animal models, which was consistent with inhibition of angiogenesis as determined by evaluating VEGF expression and tumor microvessel formation. In gastric cancer specimens, loss or decrease in RUNX3 expression inversely associated with increased VEGF expression and elevated microvessel formation. CONCLUSIONS: Our clinical and experimental data provide a novel molecular mechanism for the antitumor activity of RUNX3 and may help design effective therapy targeting RUNX3 pathway to control gastric cancer growth and metastasis.     

The effect of the expression of vascular endothelial growth factor (VEGF)-C and VEGF receptor-3 on the clinical outcome in patients with gastric carcinoma

Aims

We aimed to investigate the relationship among VEGF-C/VEGFR-3 expression, lymphatic metastasis and patient prognosis in gastric carcinoma.

Material and methods

VEGF-C and VEGFR-3 expression in gastric carcinoma tissues obtained from 204 patients who underwent curative gastrectomy (105 cases presented with lymph node metastasis and 99 cases without metastasis) was examined immunohistochemically. There was no significant difference in the other clinicopathologic variables except for postoperative pathological tumor stage (pT) and TNM stage between the two groups. The results were statistically processed.

Results

The results showed that VEGF-C was located mainly in the cytoplasm of tumor cells and VEGFR-3 was found predominantly in the endothelium of lymphatic vessels. VEGF-C and VEGFR-3 expression was more frequent in gastric carcinoma tissues than that in normal gastric tissues, 54.90% and 35.29% respectively, which revealed that the expression of VEGF-C and VEGFR-3 was significantly stronger in patients with lymph node metastasis than in those without metastasis. Patients who had positive staining for VEGF-C showed significantly less favorable survival rates compared with patients who had negative staining for VEGF-C. The survival rates of patients who had positive staining for VEGFR-3 also were significantly lower compared with patients who had negative staining for VEGFR-3. Patients who had positive staining for both VEGF-C and VEGFR-3 exhibited the most unfavorable prognosis. Multivariate analysis demonstrated that the expression of VEGF-C and VEGFR-3 was an independent prognostic determinant. In addition, faint to moderate VEGF-C expression was detected in normal gastric epithelial cells (18/204, 8.9%).

Conclusions

VEGF-C and VEGFR-3 expression could serve as a prognostic biomarker in patients with gastric carcinoma.     

Positive correlation of osteopontin, cyclooxygenase-2 and vascular endothelial growth factor in gastric cancer

Osteopontin (OPN), cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) are overexpressed in various experimental models of malignancy. However, the correlation and role of the three molecules in gastric cancer is unclear. In the present study, we found that OPN, COX-2 and VEGF were overexpressed in 53 cancerous tissues with gastric cancer compared with 40 normal mucosa tissues by immunohistochemistry method. Moreover, the results indicated co-expression of OPN, COX-2, and VEGF in gastric cancer. Levels of OPN, COX-2, and VEGF were all significantly correlated with TNM stage, lymph node metastasis and distant metastasis (P < 0.05), while not related to prognosis of patients. In addition, individual levels of OPN, COX-2, and VEGF were all significantly correlated with microvessel density (MVD), valued by CD34 staining directly with r-values of 0.416, 0.400, and 0.566, respectively (P < 0.01). Both OPN and COX-2 levels showed a positive correlation with VEGF (P < 0.05). Meanwhile, expression of COX-2 is in relation to OPN (P < 0.01). Overall, survival for patients with high MVD was significantly lower than for patients with low MVD (P < 0.05). Our findings indicate that OPN, COX-2, and VEGF synergically promote angiogenesis and metastasis in gastric cancer. It may be an important and useful strategy to target these molecules for prevention and therapy of tumor.     

Reduced serum vascular endothelial growth factor receptor-2 (sVEGFR-2) and sVEGFR-1 levels in gastric cancer patients

The relationship between gastric cancer and serum vascular endothelial growth factor receptor-1 (sVEGFR-1) and sVEGFR-2, which are soluble form receptor proteins of vascular endothelial growth factor (VEGF), has not been extensively studied. VEGF, sVEGFR-1 and sVEGFR-2 were measured in the sera obtained before surgical operation from 164 gastric cancer patients and from 164 healthy controls matched for age and gender. Compared with controls, the cases showed elevated VEGF (P < 0.01) and reduced sVEGFR-1 (P = 0.07) and sVEGFR-2 (P = 0.02). The difference in VEGF levels was small among men and when the outcome was early cancer. The difference in sVEGFR-1 levels was significant or borderline significant only in men and when the outcome was diffuse type cancer. The difference in sVEGFR-2 levels was significant only in men and when the outcome was advanced or diffuse type cancer. The sensitivities and specificities of VEGF, sVEGFR-1 and sVEGFR-2 were all approximately 60%. For diffuse type cancer, sVEGFR-2 showed a sensitivity of 62.4% and a specificity of 63.4%, which was similar to serum pepsinogen. In conclusion, elevated VEGF and reduced sVEGFR-1 and sVEGFR-2 in serum are characteristic of gastric cancer patients, and the value of serum sVEGFR-2 in the diagnosis of diffuse type gastric cancer should be further evaluated.     

Gene therapy of prostate cancer with the soluble vascular endothelial growth factor receptor Flk1

A variety of novel therapeutic approaches have emerged recently for the treatment of human cancers. We have coupled two of these therapeutic approaches, gene therapy and antiangiogenic therapy and tested them in two murine prostate cancer models Recombinant adenovirus encoding the ligand-binding ectodomain of the VEGF receptor 2 (Flk1) fused to an Fc domain was administered to SCID mice carrying orthotopic human LNCaP tumors as well as to transgenic (TRAMP) mice with spontaneous prostate tumors. Ad Flk1-Fc injection reduced tumor growth by 66% for orthotopic LNCaP tumors and by 42% for spontaneous tumors in TRAMP mice. Microvessel density in the primary tumors was reduced by 68% and 40% in the two models respectively. A decrease in microvessel density was also observed in lymphatic metastases in Ad Flk1-Fc-treated TRAMP mice and was correlated with a decrease in the frequency of regional metastases in the treated animals. Survival time was also extended in the Ad Flk1-Fc-treated TRAMP mice relative to the control-treated animals. Our results suggest that adenoviral delivery of soluble Flk1 receptor can reduce vascular density and prostate tumor growth and prolong survival time in orthotopically implanted tumors as well as in spontaneous prostate tumors in transgenic animals.     

血清可溶性血管内皮生长因子受体1在子宫内膜癌患者中的表达及与疾病特征的关系

目的探讨子宫内膜癌患者血清可溶性血管内皮生长因子受体1(sVEGFR1)的表达情况以及其与患者基线特征的关系。方法选取82例子宫内膜癌患者(子宫内膜癌组)和75例同期女性健康体检者(健康对照组)。采用酶联免疫吸附试验(ELISA)检测两组研究对象血清sVEGFR1的表达水平,并分析不同基线特征的子宫内膜癌患者的血清sVEGFR1表达情况。结果子宫内膜癌组患者的血清sVEGFR1表达水平为(213.52±77.46)ng/ml,低于健康对照组的(843.47±141.05)ng/ml(P﹤0.05)。不同组织分化程度、TNM分期的子宫内膜癌患者的血清sVEGFR1表达水平比较,差异均有统计学意义(P﹤0.01);有淋巴结转移、肌层浸润深度≥50%的子宫内膜癌患者的血清sVEGFR1表达水平均明显低于无淋巴结转移、肌层浸润深度﹤50%的患者(P﹤0.01);不同年龄、绝经情况及病理类型的子宫内膜癌患者的血清sVEGFR1表达水平比较,差异均无统计学意义(P﹥0.05)。结论与健康体检者比较,子宫内膜癌患者的血清sVEGFR1表达水平较低,血清sVEGFR1表达水平与患者的组织分化程度、TNM分期、淋巴结转移情况、肌层浸润深度有关,可能成为子宫内膜癌早期诊断的潜在的生物学标志物。     

Impact of HER2 expression on outcome in gastric cancer patients with liver metastasis

Purpose

We aim to investigate the correlation of HER2 expression with liver metastasis and the impact of HER2 status and trastuzumab therapy on the prognosis of gastric cancer with liver metastasis (GCLM) patients.

Methods

This prospective observational study was carriedout in Shanghai Zhongshan Hospital, Fudan University, from January 2012 to June 2015. HER2 status and baseline characteristics were collected from the patient record. GCLM patients were divided into three groups according to HER2 status and trastuzumab therapy.

Results

A total of 290 patients were included, and94 patients were diagnosed with liver metastasis. The HER2 positivity was 37.2 % (35/94) in GCLM patients and 21 % (61/290) in the overall GC patients. Among 94 GCLM patients, 28 HER2-positive patients received trastuzumab-based therapy (group A), 7 HER2-positive patients received chemotherapy alone (group B) and the other 59 patients were HER2 negative (group C). The median progression-free survival (PFS) for groups A, B and C was 7.83, 6.30 and 5.33 months, respectively (P = 0.007). The median overall survival (OS) for groups A, B and C was 12.00, 10.47 and 8.67 months, respectively (P = 0.056). Further Cox analysis showed that there was no significant difference in OS (P = 0.917) and PFS (P = 0.456) between group B and C.

Conclusions

HER2 positivity was higher in GCLM patients. HER2 status itself was not an independent prognostic factor in GCLM patients. Trastuzumab-based therapy could significantly improve survival in HER2-positive GCLM patients.

     

Prognostic value of vascular endothelial growth factor expression in colorectal cancer patients

Solid tumours require neovascularisation for growth and metastasis. Vascular endothelial growth factor (VEGF) has been shown to be an important regulator of tumour angiogenesis. To examine the relevance of VEGF in the neoplastic transformation of human colon, we analysed protein expression in a total 30 polyps and 145 colorectal carcinomas by immunohistochemistry. All adenoma specimens, regardless of histological differentiation, and normal colonic mucosa did not express VEGF. Amongst 90 patients with non-metastatic colorectal cancer, VEGF expression was observed in 43 (48%) cases, whilst 29 of the 55 patients (53%) with metastases expressed the angiogenic factor. Both the proportion and intensity of VEGF expression were positively associated with the progression of colon carcinogenesis. Tumours with the highest VEGF expression tended to correlate with patients' survival, although VEGF expression did not emerge as an independent risk factor in a multivariate analysis. After exclusion of the patients with distant metastases, both univariate and multivariate analysis did not indicate any prognostic value for the tissues with the highest VEGF expression. Our results suggest that VEGF may play a role in the progression of colon cancer, although evaluation of this angiogenic phenotype did not provide additional prognostic information compared with that obtained from Dukes' staging of the tumours.     

Combined analysis of vascular endothelial growth factor and platelet-derived endothelial cell growth factor expression in gastric carcinoma

Solid tumours require neovascularization for growth and metastasis. Both vascular endothelial growth factor (VEGF) and platelet-derived endothelial cell growth factor (PD-ECGF) are well-characterized inducers of angiogenesis. In this study we examined the expressions of these antigens and their relationship with microvessel density and also determined their prognostic significance. Ninety-five specimens resected from patients with gastric carcinoma were investigated using immunohistochemical methods. Microvessel density, determined by immunostaining for factor VIII-related antigen, was significantly higher in tumours that were both VEGF⁺ and PD-ECGF⁺ than in tumours that were both VEGF⁻ and PD-ECGF⁻. According to prognosis, patients with VEGF⁺ tumours had a significantly worse prognosis than did those with VEGF⁻ tumours. Although there was no significant correlation between PD-ECGF expression and prognosis, patients with PD-ECGF⁺ tumours tended to have a shorter survival than did those with PD-ECGF⁻ tumours. Moreover, the frequency of hepatic recurrence was significantly higher in patients with tumours that were both VEGF-positive and PD-ECGF⁺ than in all other patients. Int. J. Cancer 74:545–550, 1997. © 1997 Wiley-Liss, Inc.     

表皮生长因子受体、血管内皮生长因子受体和BAD在非小细胞肺癌中的表达

背景与目的：表皮生长因子受体（epidermal growth factor receptor，EGFR）和血管内皮生长因子受体（vascular endothelial growth factor receptor，VEGFR）均属酪氨酸激酶受体（receptor tyrosine kinase，RTK），可调控细胞的增殖、分化与生存。BAD是Bcl-2家族中的促凋亡信号成分，在调控细胞凋亡特别是肿瘤细胞凋亡过程中发挥重要作用。但目前人们对上述这些重要蛋白在非小细胞肺癌（non—small—cell lung cancer，NSCLC）中的表达与肿瘤病理学的关系所知甚少。本研究探讨ECFR、VEGFR、BAD和磷酸化BAD在NSCLC中的表达情况以及与肿瘤病理的关系。方法：使用组织微阵列（tissue microarray，TMA）切片的免疫组织化学法，NSCLC患者51例（26例腺癌，16例鳞癌，8例大细胞癌，1例大细胞神经内分泌癌）。结果：51例患者中EGFR和VEGFR分别在10例（加％）和14例（27％）中出现过度表达。大细胞癌中未见VEGFR表达（0／8例），而鳞癌和腺癌患者中VEGFR表达分别为44％（7／16）和27％（7／26）。EGFR和VEGFR的表达与性别，肿瘤细胞分化及肿瘤浸润程度（包括胸膜浸润，血管浸润，淋巴结转移，肺内播散，脑转移情况）无关。51例患者中22例（43％）出现BAD蛋白表达缺失，且NSCLC的不同病理类型间差异有显著性。BAD蛋白表达缺失在16例鳞癌患者中10例（63％），8例大细胞癌患者中5例（63％），26例鳞癌患者中有7例（27％）（P=0．04）。51例患者中25例（49％）出现磷酸化BAD蛋白过度表达[其中26例腺癌患者中有13例（50％），16例鳞癌患者中有8例（50％），8例大细胞癌患者中有4例（50％）]。BAD蛋白的表达缺失与磷酸化BAD蛋白的过度表达经统计检验与上述肿瘤浸润程度无相关性。结论：肺鳞癌出现VEGFR表达增高的可能较大，而大细胞癌出现VEGFR表达增高的可能最小。在鳞癌和大细胞癌中可见BAD蛋白表达的显著缺失。NSCLC患者EGFR，VEGFR，磷酸化BAD蛋白的过度表达以及BAD蛋白表达的缺失与病理浸润程度无关。但这些受体酪氨酸激酶表达以及与NSCLC凋亡直接相关的媒介因子可能成为未来多靶向治疗中的候选靶标。     

The effects of neoadjuvant anastrozole and tamoxifen on circulating vascular endothelial growth factor and soluble vascular endothelial growth factor receptor 1 in breast cancer.

PURPOSE: Vascular endothelial growth factor (VEGF) is a key angiogenic factor mediating neovascularization. Soluble VEGF receptor 1 (sVEGFR-1) is an intrinsic negative counterpart of VEGF signaling and the ratio of sVEGFR-1 to VEGF has been shown to be a prognostic factor. Estrogen-bound estrogen receptor enhances VEGF expression, providing a common link between these signaling pathways that may be targeted by endocrine therapy. We investigated the effects of anastrozole and tamoxifen over time on serum VEGF and sVEGFR-1. EXPERIMENTAL DESIGN: The Immediate Preoperative Anastrozole, Tamoxifen, or Combined with Tamoxifen (IMPACT) trial compared the preoperative use of anastrozole with tamoxifen in postmenopausal women with estrogen receptor-positive primary operable breast cancer over 12 weeks. Circulating VEGF and sVEGFR-1 were measured by ELISA in 106 patients treated with anastrozole or tamoxifen alone at baseline and after 2 and 12 weeks of treatment. RESULTS: The increase in serum VEGF from baseline to 12 weeks was significantly different between anastrozole and tamoxifen (anastrozole versus tamoxifen, 6% versus 38%; P = 0.047). There was a significant increase in sVEGFR-1 levels after 12 weeks of anastrozole (P = 0.037). The sVEGFR-1/VEGF ratio significantly decreased in the tamoxifen arm (P = 0.013) and the change in sVEGFR-1/VEGF ratio from baseline to 12 weeks was significantly different between anastrozole and tamoxifen (anastrozole versus tamoxifen, 24% increase versus 34% decrease; P = 0.013). CONCLUSIONS: Treatment with anastrozole and tamoxifen resulted in differential effects on serum angiogenic markers. This may be related to the relative effectiveness of the treatments. These data provide further support for cross talk between estrogen receptor and VEGF.