Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Cancer Biol Ther. 2012 Mar;13(5):247-63. doi: 10.4161/cbt.19594.
Several therapies targeting angiogenesis are currently in development for non-small cell lung cancer (NSCLC). This review discusses results of recent clinical trials evaluating chemotherapy plus antiangiogenic therapy for NSCLC. Bevacizumab, an anti-VEGF antibody, is currently approved for the treatment of advanced NSCLC in combination with carboplatin and paclitaxel. Completed phase III trials evaluating bevacizumab plus chemotherapy have shown prolonged progression-free survival; however, not all trials showed significant improvement in overall survival (OS). Phase III trials of the tyrosine kinase inhibitors (TKIs) vandetanib and sorafenib and the vascular disrupting agent ASA404 also failed to improve OS compared with chemotherapy alone. Clinical trials are ongoing involving several new antiangiogenic therapies, including ramucirumab, aflibercept, cediranib, BIBF 1120, sunitinib, pazopanib, brivanib, ABT-869, axitinib, ABT-751, and NPI-2358; several of these agents have shown promising phase I/II results. Results from recently completed and ongoing phase III trials will determine if these newer antiangiogenic agents will be incorporated into clinical practice.
目前有几种针对血管生成的疗法正在开发中，用于治疗非小细胞肺癌（NSCLC）。本文讨论了最近评估化疗联合抗血管生成疗法治疗 NSCLC 的临床试验结果。贝伐珠单抗（bevacizumab）是一种抗 VEGF 抗体，目前被批准与卡铂和紫杉醇联合用于治疗晚期 NSCLC。已完成的评估贝伐珠单抗联合化疗的 III 期临床试验显示无进展生存期延长；然而，并非所有试验均显示总生存期（OS）有显著改善。III 期酪氨酸激酶抑制剂（TKI）vandetanib 和 sorafenib 以及血管破坏剂 ASA404 的临床试验与单独化疗相比，也未能改善 OS。目前正在进行几项新的抗血管生成疗法的临床试验，包括 ramucirumab、aflibercept、cediranib、BIBF 1120、sunitinib、pazopanib、brivanib、ABT-869、axitinib、ABT-751 和 NPI-2358；其中一些药物已显示出有前景的 I/II 期结果。最近完成和正在进行的 III 期临床试验的结果将确定这些新的抗血管生成药物是否将纳入临床实践。
