Angiogenesis is essential to cancer development and progression, and its inhibition has been shown to benefit patients with several different malignancies. A considerable number of antiangiogenic compounds have been evaluated for the treatment of colorectal cancer, but only bevacizumab and aflibercept were able to demonstrate a survival benefit in phase III trials. In this review, we discuss important aspects of the interrelationship between tumor cells and the microenvironment leading to tumor progression, with a focus on angiogenesis. Clinical data on antiangiogenic therapies for colorectal cancer in the metastatic and adjuvant settings, as well as the potential use of antiangiogenics beyond tumor progression are analyzed. The need to identify surrogate biomarkers towards a more personalized approach in oncology is emphasized as this is becoming increasingly important in drug development.
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