Anti-angiogenic agents in the age of resistance to immune checkpoint inhibitors: Do they have a role in non-oncogene-addicted non-small cell lung cancer?
Date
2020-06-01ICR Author
Author
Popat, S
Grohé, C
Corral, J
Reck, M
Novello, S
Gottfried, M
Radonjic, D
Kaiser, R
Type
Journal Article
Metadata
Show full item recordAbstract
The introduction of licensed front-line immunotherapies has heralded a new era for the treatment of non-oncogene-addicted, advanced non-small cell lung cancer (NSCLC). Yet as with all evolutions in clinical management, changes in practice can outpace the availability of the clinical evidence needed to inform subsequent therapeutic decision making. At the time of writing, there is limited available evidence on the optimum therapeutic options after progression on immunotherapy. Further research is needed to define mechanisms of immunotherapy resistance in patients with advanced NSCLC, and to understand the implications for subsequent treatment response. Pending the availability of robust clinical data and proven therapeutic options to underpin an optimized therapeutic pathway after progression on immunotherapy, attention must turn to the potential utility of currently licensed agents and any available supporting clinical data in this setting. Within this context we review the mechanistic arguments and supporting evidence for the use of anti-angiogenic agents as a means of targeting immunosuppression within the tumor microenvironment. We consider whether VEGF inhibition may help to normalize the tumor vasculature and to address immunosuppression - reinstating, and potentially enhancing, the effect of subsequent therapies. We also highlight evidence needs and signpost ongoing trials that should enable current clinical opinion in this area to be replaced by robust, evidence-based guidance.
Collections
Subject
Anti-angiogenic drug
Immunotherapy resistance
Nintedanib
Non-oncogene-addicted non-small cell lung cancer (NSCLC)
Tumor microenvironment (TME)
Vascular endothelial growth factor (VEGF)
Angiogenesis Inhibitors
Carcinoma, Non-Small-Cell Lung
Humans
Immune Checkpoint Inhibitors
Immunotherapy
Lung Neoplasms
Tumor Microenvironment
Language
eng
Date accepted
2020-04-09
License start date
2020-06-01
Citation
Lung Cancer, 2020, 144 pp. 76 - 84
Publisher
ELSEVIER IRELAND LTD