Angiogenesis and Nutritional Oncology: New Frontiers in the Approach to Cancer Therapy

At the 2020 virtual conference of the Cholangiocarcinoma Foundation (CCF), William W. Li, MD, Chief Executive Officer, President, and Medical Director of the Angiogenesis Foundation in Cambridge, MA, presented the keynote address titled “Dietary Modification of the Tumor Microenvironment: New Frontiers in Cancer Research and Therapy.”

Founded in 1994, the Angiogenesis Foundation remains the world’s only organization dedicated exclusively to unlocking the mystery and promise of angiogenesis for the treatment of patients with cancer. The foundation is recognized as the world’s top authority on scientific and clinical research related to angiogenesis, including drug and device developments. The foundation is focused on bringing the benefits of angiogenesis-based treatments and prevention to patients around the world.

Bruce Coppock, Vice Chair, CCF Board of Directors, introduced Dr Li, explaining how Dr Li saved his life after his once-successful therapy for his diagnosis of cholangiocarcinoma (CCA) was failing. Dr Li recommended a combination of drugs that Mr Coppock is still using to this day to manage his CCA.

Genomic and Molecular Nutrition

Dr Li’s presentation took a deep dive into how molecular nutrition and nutritional oncology will play critical roles in cancer medicine in the future. He presented data that support the idea that food can have an impact on patient outcomes. A movement is already taking place globally, where disparate groups such as the insurance health plans, medical societies, religious organizations, and even federal regulators are examining how poor nutrition can play a key role in the onset of diseases, as well as how proper nutrition can help to prevent and manage diseases.

With the myriad of nutritional supplements on the market and the onslaught of advertising, patients are often confused by the claims for health benefits they see online and on television.

The rigor that pharmaceuticals undergo in randomized controlled clinical trials is lacking in the nutritional supplement industry. That is where the Angiogenesis Foundation hopes to make a difference, by providing rigorous scientific evidence related to nutrition and supplements. Dr Li discussed how medical evidence is being developed to show that foods can be therapeutic.

Food Is Medicine

“In reconceptualizing the burden of evidence that food is medicine, one of the things that we are working on is looking beyond clinical trials alone and examining the genomic and molecular evidence: in vitro, in vivo, and ex vivo data; biomarker studies (both in animals and humans); population studies; and of course, varying sizes and designs of clinical trials,” Dr Li emphasized.

With Dr Li’s focus on angiogenesis, the Angiogenesis Foundation examined the role that food and their extracts can play in the disruption of new blood vessel development in solid tumors. In a drug development system that he and his colleagues designed, they showed that you can get results that look similar to or are more potent than some pharmaceuticals, including anticancer drugs. The results are intriguing and hypothesis-generating, but they still need to be tested in humans.

“Think of your body as a fortress that is hardwired to defend itself,” Dr Li told the audience. He outlined the 3 human defense mechanisms that are especially important in oncology and in the development of tumors, including:

1. AngiogenesisAngiogenesis is the normal physiological process responsible for the formation of new blood vessels from existing blood vessels. This vital growth process is also involved in the formation of some diseases, including cancer.

   Tumors are able to hijack the normal process of new blood vessel growth for their own survival. Phytoestrogens, such as the ones found in soy; lycopenes, which are found in tomatoes; and citrus fruits have all been shown to inhibit angiogenesis.

2. RegenerationHumans do have the ability to regenerate tissue by using stem cells. Normal aging process results in the loss of stem cells; this is also the case with diets that are high in fat and salt, and diets that are hyperglycemic (involving an excess of sugar in the bloodstream). However, Dr Li pointed out, other diets, such as the Mediterranean and Okinawan diets, calorie-restricted diets, and intermittent-fasting diets can all lead to an enhanced stem-cell regeneration in response to injury, illness, and surgery diets.
3. Microbiome and the immune systemThe microbiome and the immune system are linked together in a very important way. The microbiome consists of a complex mixture of substances, including bacteria, fungi, viruses, and other microbes. A healthy crosstalk between the gut microbiota and the immune system supports the body’s protective responses against pathogens, promotes tolerance to harmless microbes and their products, and helps to maintain self-tolerance—the ability of our immune system not to react to living organisms and processes in a way that is harmful to our body.

Dr Li emphasized that a healthy gut starts and ends with a healthy diet.

“We cannot accept yesteryears’ limitations, and they need to be reconsidered. We have more that we can achieve with cancer, and we need to push the bar forward, not only with immunotherapy but also with nutritional oncology,” Dr Li concluded.