ABSTRACT

Progressive angiogenesis and tumor metastasis characterize advanced-stage ovarian cancer and ultimately lead to poor outcome, with 5-year survival rates <30%.1 A better understanding of the biologic mechanisms by which ovarian cancer grows and metastasizes is paramount to improving this dismal outcome. Cancer metastasis requires a sequential cascade of interrelated events between the cancer cell and its microenvironment.2 Following transformation into a malignant phenotype and evasion of the body’s immune and nonimmune defenses, tumor cells will grow to a critical mass of about 1 mm3.2

Growth beyond this size and subsequent metastasis depend on the ability of the tumor to initiate and maintain a sufficient vascular network (angiogenesis).