Division of Hematology/Oncology, Case Western Reserve University, Case Comprehensive Cancer Center, Cleveland, OH 44106, USA.
Clin Lung Cancer. 2008 Mar;9 Suppl 2:S71-5. doi: 10.3816/CLC.2008.s.011.
The recent approval of bevacizumab, sunitinib, and sorafenib in a number of diseases has led to significant interest in expanding the role of antiangiogenic therapies in cancer. Specifically, bevacizumab has only received approval for a relatively selective population with advanced non-squamous non-small-cell lung cancer (NSCLC) with good performance status and without coagulopathy, brain metastases, or hemoptysis. This has significantly restricted the potential benefit bevacizumab can bring to patients with lung cancer. In order to address whether bevacizumab might be beneficial in other settings, a multitude of clinical trials are ongoing. These include questions such as the safety of bevacizumab in patients with hemoptysis, brain metastases, and squamous cell histology. The use of bevacizumab is also being addressed in locally advanced and early-stage lung cancer. The results of many of these trials will be available in the next 2-3 years. Unfortunately, as in the case of many targeted therapies, we lack a specific biomarker to predict response to these agents. In addition, although antiangiogenic trials are well under way in NSCLC, this is not the case for small-cell lung cancer, a highly angiogenic disease in which the pace of research is substantially slower.
最近，贝伐单抗、舒尼替尼和索拉非尼在多种疾病中的批准，使得人们对扩大抗血管生成疗法在癌症中的作用产生了浓厚的兴趣。具体来说，贝伐单抗仅被批准用于晚期非鳞状非小细胞肺癌（NSCLC）中具有良好表现状态、无凝血功能障碍、脑转移或咯血的选择性人群。这极大地限制了贝伐单抗为肺癌患者带来的潜在益处。为了确定贝伐单抗在其他情况下是否可能有益，目前正在进行大量临床试验。这些试验包括贝伐单抗在咯血、脑转移和鳞状细胞组织学患者中的安全性等问题。贝伐单抗的使用也在局部晚期和早期肺癌中得到了探讨。这些试验的许多结果将在未来 2-3 年内公布。不幸的是，就像许多靶向治疗一样，我们缺乏一个特定的生物标志物来预测对这些药物的反应。此外，尽管 NSCLC 的抗血管生成试验进行得如火如荼，但小细胞肺癌并非如此，小细胞肺癌是一种高度血管生成的疾病，其研究速度要慢得多。
