The interplay between angiogenesis and cervical cancer: a comprehensive review

Cervical cancer is still a major global health threat, specifically in countries with little access to health services. Angiogenesis in cervical cancer not only contributes to tumor growth, metastasis, and resistance to therapy but also serves as a therapeutic target itself. This gives hope for the possible therapy. This review covers key molecular mechanisms in cervical cancer, including VEGF/VEGFR, HIF-1α, and PI3K/Akt pathways. It also discusses anti-angiogenic therapies like bevacizumab, small-molecule compounds, and emerging approaches such as nanoparticle-based drug delivery. Emphasis is placed on angiogenesis-related biomarkers for diagnosis and treatment selection, stressing the need for affordable therapies in low-resource settings. A literature search was conducted using PubMed, Scopus, and Google Scholar up to March 2025, focusing on VEGF/VEGFR signaling, anti-angiogenic therapies, and resistance mechanisms in cervical cancer. Despite promise, resistance, toxicity, and cost remain major challenges for anti-angiogenic therapy's clinical use. Combination strategies with immunotherapy, chemotherapy, and targeted agents may be more effective. Precision medicine using multi-omics and AI offers hope for better outcomes. Future studies should evaluate drug combinations with synergistic effects and develop management strategies to universalize innovative treatments.