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Anti-DLL4 refers to a class of monoclonal antibodies designed to inhibit Delta-like ligand 4 (DLL4), a transmembrane protein that serves as a ligand for Notch receptors. DLL4 is primarily expressed in the vascular endothelium and plays a critical role in regulating angiogenesis and maintaining cancer stem cell (CSC) populations. Unlike traditional anti-angiogenic agents like VEGF inhibitors that reduce vessel density, anti-DLL4 treatment typically promotes "non-productive" angiogenesis, characterized by excessive but disorganized vessel sprouting and branching that leads to poor tumor perfusion and inhibited growth. Furthermore, DLL4 inhibition has been shown to reduce the frequency of tumor-initiating cells (cancer stem cells), which may help prevent tumor recurrence and metastasis. Several pharmaceutical companies, including OncoMed Pharmaceuticals and Regeneron, have developed anti-DLL4 candidates (such as demcizumab and enoticumab, respectively) for the treatment of various solid tumors, often in combination with chemotherapy or other targeted therapies.
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