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 The Folkman Laboratory
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Inhibiting Angiogenesis

By the 1980s, Folkman's team turned its attention to the search for molecules that could turn off angiogenesis in tumors. This was a daunting task: no such molecules were known, and few scientists believed they even existed.

The first angiogenesis inhibitor to be identified was interferon-alpha, a natural protein in the body known for its antiviral activity. Bruce R. Zetter, Ph.D., in Folkman's lab showed in the early 1980s that interferon-alpha could also stop endothelial cells from moving and migrating toward a tumor; other scientists then showed the protein's anti-angiogenic activity. Interferon-alpha entered clinical trials for the treatment of life-threatening hemangiomas (masses of blood capillaries) in children in 1989. Folkman and Children's Hospital colleagues Alan Ezekowitz, M.B., Ch.B., D.Phil., now Chief of Pediatrics at the MassGeneral Hospital for Children, and John B. Mulliken, M.D., now director of the Craniofacial Center at Children's Hospital, developed the most extensive clinical experience with this new anti-angiogenic therapy for children. Interferon-alpha is now used in children's hospitals worldwide for severe hemangiomas that fail to respond to conventional therapy, and other anti-angiogenic therapy, has recently been used for severe hemangiomas.

Other early angiogenesis inhibitors from Folkman's lab included:

  • The angiostatic steroids, discovered by Folkman in 1983. This discovery provided further evidence for anti-angiogenic compounds occurring naturally in the body. One steroid, a tetrahydrocortisol analogue, is currently in a clinical trial for patients with macular degeneration.

  • TNP-470, a synthetic version of an angiogenesis inhibitor discovered accidentally by Donald E. Ingber, M.D., Ph.D., in 1985. (Ingber isolated the original inhibitor from a mold contaminating a culture dish.) TNP-470 entered clinical trials for cancer patients in 1992, showing activity against an unusually broad spectrum of cancers. It has now been reformulated to eliminate the neurotoxicity observed in some patient studies.

  • Thalidomide, which was discovered to be an angiogenesis inhibitor in 1994 by Robert J. D'Amato, M.D., Ph.D. Once taken off the market because it caused severe birth defects, thalidomide and related compounds are being studied in at least 50 clinical trials for a variety of cancers.
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