As angiogenesis is essential for tumor growth and progression, anti-angiogenic therapies have been developed to improve the outcomes of cancer patients. Several agents, including bevacizumab, aflibercept and most recently ramucirumab that target the VEGF/VEGFR signaling pathway, have been approved across some cancer types. In addition, multi-targeted tyrosine kinase inhibitors (TKIs), such as sorafenib and sunitinib, also block angiogenesis signaling. However, the overall response rate of these anti-angiogenic therapies is unsatisfactory in the clinic. Therefore, selecting out the patients, who would benefit from anti-angiogenic treatment, will help to promote therapy efficacy and avoid unnecessary toxic adverse effect. Due to the high tissue specificity and stability of miRNAs and their altered expression in tumor angiogenesis, miRNAs have been suggested as potent predictive biomarkers for therapeutic response (Table 4).Table 4Tissue and blood miRNA biomarkers for anti-angiogenesis therapeutic responseClinical OutcomesmiRNAsSample typeDetection timeTherapyCancerPatient cohortaRefBetter outcomesmiR-378tissuepost-therapybevacizumabovarian cancer113/34miR-455-5ptissuepost-therapybevacizumabmCRC212/121miR-221tissuepost-therapysunitinibmRCC30/27miR-155, miR-484tissuepost-therapysunitinibmRCC16/63miR-126bloodpre- and post-therapybevacizumabmCRC75/68miR-665bloodpre-therapybevacizumab/erlotinibNSCLC51/50Worse outcomesmiR-664-3p,tissuepost-therapybevacizumabmCRC212/121miR-425-3ptissuepre- and post-therapysorafenibHCC26/58miR-223bloodpre-therapybevacizumab/erlotinibNSCLC51/50mCRC metastatic colorectal cancer, HCC hepatocellular carcinoma, mRCC metastatic renal cell carcinoma, NSCLC non-small-cell lung canceraThe pattern A/B represents patient number in training cohort and validation cohort respectively