Antiangiogenic therapy in nonsmall cell lung cancer.

Overview

PURPOSE OF REVIEW: The use of targeted therapies, particularly those against the key mediator of angiogenesis, vascular endothelial growth factor, has the potential to improve outcomes for nonsmall cell lung cancer (NSCLC) patients. This review summarizes recent findings on targeting mediators of angiogenesis, treatment options and molecular targets in development. RECENT FINDINGS: Bevacizumab, a recombinant humanized monoclonal antivascular endothelial growth factor antibody, in a phase III study, showed significantly improved overall and progression-free survival when used in combination with standard first-line chemotherapy in patients with advanced NSCLC and was generally well tolerated. Adverse events, including tumor-related bleeding, have been noted in some patients, predominantly those with squamous cell histology or centrally located tumors. SUMMARY: Several small-molecule vascular endothelial growth factor receptor tyrosine kinase inhibitors have also shown promise in phase I and II trials in NSCLC. This review summarizes the most important findings on angiogenesis inhibitors in NSCLC and discusses the potential for the use of these novel agents in different settings.