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Angiogenesis inhibition in non-small cell lung cancer: a critical appraisal, basic concepts and updates from American Society for Clinical Oncology 2019
- Source :
- Current opinion in oncology. 32(1)
- Publication Year :
- 2019
-
Abstract
- Recently, the combination of antiangiogenic agents, chemotherapy and immunotherapy has shown synergistic anticancer effects in non-small cell lung cancer (NSCLC). The future for this approach appears bright in lung cancer treatment; however, many challenges remain to be overcome regarding its true potential, optimal sequence and timing of therapy, and safety profile. In this review, we will discuss the current status and future direction of antiangiogenic therapy for the treatment of NSCLC, and highlight emerging strategies, such as tumor vessel normalization (TVN).Bevacizumab was the first antiangiogenic agent approved for the treatment of advanced NSCLC. Recently, the combination of chemotherapy/antiangiogenic therapy with immunotherapy showed high efficacy in first-line settings. A subgroup of patients with liver metastasis and driver mutation-addicted tumors benefited most, suggesting that the metastatic location, as well as the genetic background of the tumor, are key determinants for therapy responses.The efficacy of antiangiogenic therapies in unselected patients is rather limited. The tumor microenvironment has appeared to be more complex and heterogeneous than previously assumed. Only a contextual rather than a cell-specific approach might provide valuable insights towards the clinical validation of combinational therapies.
- Subjects :
- 0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
Angiogenesis Inhibitors
Neovascularization
03 medical and health sciences
0302 clinical medicine
Internal medicine
Carcinoma, Non-Small-Cell Lung
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Medicine
Combined Modality Therapy
Humans
Lung cancer
Randomized Controlled Trials as Topic
Chemotherapy
Neovascularization, Pathologic
business.industry
Immunotherapy
respiratory system
medicine.disease
respiratory tract diseases
Clinical trial
Critical appraisal
030104 developmental biology
Clinical Trials, Phase III as Topic
030220 oncology & carcinogenesis
medicine.symptom
business
Subjects
Details
- ISSN :
- 1531703X
- Volume :
- 32
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Current opinion in oncology
- Accession number :
- edsair.doi.dedup.....9f9dd9cb3430bff76a9a2ad2b28a1edb