Cunningham Charnay, Bolcaen Julie, Bisio Alessandra, Genis Amanda, Strijdom Hans, Vandevoorde Charlot
Centre for Cardio-Metabolic Research in Africa (CARMA), Division of Medical Physiology, Stellenbosch University, Cape Town 7602, South Africa.
Radiation Biophysics Division, SSC Laboratory, NRF Ithemba LABS, Cape Town 7131, South Africa.
Pharmaceuticals (Basel). 2023 Jan 31;16(2):219. doi: 10.3390/ph16020219.
Non-small cell lung cancer (NSCLC) is the most prevalent type of lung cancer, which is the leading cause of cancer-related deaths worldwide. Over the past decades, tumour angiogenesis has been intensely studied in the treatment of NSCLC due to its fundamental role in cancer progression. Several anti-angiogenic drugs, such as recombinant endostatin (RE), have been evaluated in several preclinical and clinical trials, with mixed and often disappointing results. However, there is currently an emerging interest in RE due to its ability to create a vascular normalization window, which could further improve treatment efficacy of the standard NSCLC treatment. This review provides an overview of preclinical and clinical studies that combined RE and radiotherapy for NSCLC treatment. Furthermore, it highlights the ongoing challenges that have to be overcome in order to maximize the benefit; as well as the potential advantage of combinations with particle therapy and immunotherapy, which are rapidly gaining momentum in the treatment landscape of NSCLC. Different angiogenic and immunosuppressive effects are observed between particle therapy and conventional X-ray radiotherapy. The combination of RE, particle therapy and immunotherapy presents a promising future therapeutic triad for NSCLC.
非小细胞肺癌(NSCLC)是最常见的肺癌类型,也是全球癌症相关死亡的主要原因。在过去几十年中,肿瘤血管生成因其在癌症进展中的关键作用而在NSCLC治疗中得到深入研究。几种抗血管生成药物,如重组内皮抑素(RE),已在多项临床前和临床试验中进行评估,结果喜忧参半,往往令人失望。然而,由于RE能够创造一个血管正常化窗口,这可能进一步提高NSCLC标准治疗的疗效,目前人们对其兴趣正日益浓厚。这篇综述概述了将RE与放疗联合用于NSCLC治疗的临床前和临床研究。此外,它强调了为实现最大获益而必须克服的当前挑战;以及与粒子治疗和免疫治疗联合的潜在优势,这两种治疗方法在NSCLC治疗领域正迅速获得发展势头。在粒子治疗和传统X射线放疗之间观察到不同的血管生成和免疫抑制作用。RE、粒子治疗和免疫治疗的联合为NSCLC提供了一个有前景的未来治疗三联方案。
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