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While there are multiple strategies for inhibiting the VEGF pathway, there are potential advantages to targeting the VEGF ligand directly. In particular, by specifically targeting the ligand, a VEGF antibody disrupts only the VEGF pathway, thereby avoiding unwanted inhibitory effects on non-VEGF–mediated functions. Based on preclinical models, it has been proposed that anti-VEGF agents exert both rapid and continuous antivascular effects, including regression of existing tumor vessels, “normalization” of surviving mature vasculature, and inhibition of both new and recurrent tumor vessel growth. Specific VEGF ligand inhibition may also provide versatility to address changing tumor biology over time.
