The mechanism of action of anti-VEGF therapy is multifactorial and includes inhibition of angiogenesis, induction of epithelial cell apoptosis, direct effect on tumor cells expressing VEGF receptors, modulation of the immune system with enhanced cytotoxic T cell and dendritic cell activity, and reduced activity and accumulation of immunosuppressive T reg cells, tumor-associated macrophages, and myeloid-derived suppressor cells [29,33]. This evidence concerns the gene VEGFA and neoplasm.