Antivascular agents for non-small-cell lung cancer: current status and future directions

Expert Opin Investig Drugs. 2009 Nov;18(11):1667-86. doi: 10.1517/13543780903336050.

Abstract

Background: Despite improvements in surgery and chemo(radio)therapy which have allowed for modest advances in the treatment of patients with non-small-cell lung cancer (NSCLC), survival remains poor and further improvements are needed. Attention over recent years has focused, therefore, on targeted therapies, with notable success in the development of antivascular drugs.

Objective: To summarize the current knowledge on antivascular therapy in patients with NSCLC.

Method: Review of randomized controlled trials exploring treatment of NSCLC patients with antivascular drugs.

Results/conclusion: Bevacizumab, a humanized monoclonal antibody against the vascular endothelial growth factor (VEGF), when added to cytotoxic chemotherapy, was the first treatment to prolong the overall survival of patients with advanced NSCLC beyond 12 months, a significant breakthrough in the management of advanced NSCLC. Small-molecule tyrosine kinase inhibitors and alternative antivascular strategies such as VEGF-trap and vascular disrupting agents are also being investigated and have shown promise in clinical trials. This review summarizes the most recent and important findings in antivascular agents in NSCLC.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / pharmacology
  • Angiogenesis Inhibitors / therapeutic use*
  • Animals
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Biomarkers, Tumor
  • Carcinoma, Non-Small-Cell Lung / blood supply
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Clinical Trials as Topic
  • Drug Delivery Systems
  • Humans
  • Lung Neoplasms / blood supply
  • Lung Neoplasms / drug therapy*
  • Neovascularization, Pathologic / drug therapy
  • Randomized Controlled Trials as Topic

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Biomarkers, Tumor