VEGF-A splicing: the key to anti-angiogenic therapeutics?

Recent data indicates an anti-angiogenic function for a new class of VEGF-A isoforms. In this Opinion article, Steven Harper and David Bates discuss the emerging role of these proteins in tumourigenesis and anti-angiogenic therapeutic strategies. The physiology of microvessels limits the growth and development of tumours. Tumours gain nutrients and excrete waste through growth-associated microvessels. New anticancer therapies target this microvasculature by inhibiting vascular endothelial growth factor A (VEGF-A) splice isoforms that promote microvessel growth. However, certain VEGF-A splice isoforms in normal tissues inhibit growth of microvessels. Thus, it is the VEGF-A isoform balance, which is controlled by mRNA splicing, that orchestrates angiogenesis. Here, we highlight the functional differences between the pro-angiogenic and the anti-angiogenic VEGF-A isoform families and the potential to harness the synthetic capacity of cancer cells to produce factors that inhibit, rather than aid, cancer growth.