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Published on: September 8, 2023
Rationale for targeting VEGF, FGF, and PDGF for the treatment of NSCLC
Marc S Ballas1, Abraham Chachoua
1Department of Medicine (Cancer Center), New York University Langone School of Medicine, New York, NY, USA;
Abstract:
Lung cancer remains a leading cause of death globally, with the most frequent type, nonsmall cell lung cancer (NSCLC), having a 5-year survival rate of less than 20%. While platinum-based doublet chemotherapy is currently first-line therapy for advanced disease, it is associated with only modest clinical benefits at the cost of significant toxicities. In an effort to overcome these limitations, recent research has focused on targeted therapies, with recently approved agents targeting the epidermal growth factor receptor and vascular endothelial growth factor (VEGF) signaling pathways. However, these agents (gefitinib, erlotinib, and bevacizumab) provide antitumor activity for only a small proportion of patients, and patients whose tumors respond inevitably develop resistance to treatment. As angiogenesis is a crucial step in tumor growth and metastasis, antiangiogenic treatments might be expected to have antitumor activity. Important targets for the development of novel antiangiogenic therapies include VEGF, fibroblast growth factor, platelet-derived growth factor, and their receptors. It is hypothesized that targeting multiple angiogenic pathways may not only improve antitumor activity but also reduce the risk of resistance. Several novel agents, such as BIBF 1120, sorafenib, sunitinib, and cediranib have shown promising preliminary activity and tolerability in Phase II studies, and results of ongoing Phase III randomized studies will be necessary to establish the potential place of these new therapies in the management of individual patients with NSCLC.
Insights
Lung cancer survival rates are low, and current treatments have limited benefits and significant toxicities. Novel antiangiogenic therapies targeting multiple pathways show promise for improving outcomes in nonsmall cell lung cancer (NSCLC).
Area of Science:
- Oncology
- Cancer Research
- Pharmacology
Background:
- Lung cancer, particularly nonsmall cell lung cancer (NSCLC), has a poor prognosis with current first-line chemotherapy.
- Existing targeted therapies (e.g., EGFR, VEGF inhibitors) show limited efficacy and lead to acquired resistance.
- Angiogenesis is critical for tumor growth and metastasis, making it a key target for novel cancer treatments.
Purpose of the Study:
- To explore the potential of novel antiangiogenic therapies for NSCLC.
- To investigate targeting multiple angiogenic pathways to improve antitumor activity and overcome resistance.
- To evaluate preliminary activity and tolerability of new agents in NSCLC.
Main Methods:
- Review of current literature on lung cancer treatment and targeted therapies.
- Identification of key angiogenic pathways and potential therapeutic targets (VEGF, FGF, PDGF).
- Summary of preliminary findings from Phase II studies of novel antiangiogenic agents (BIBF 1120, sorafenib, sunitinib, cediranib).
Main Results:
- Novel antiangiogenic agents have shown promising preliminary activity and tolerability in Phase II studies.
- Targeting multiple angiogenic pathways is hypothesized to enhance antitumor effects and reduce resistance.
- Ongoing Phase III studies are crucial to confirm the efficacy of these new therapies.
Conclusions:
- Current NSCLC treatments are insufficient, necessitating novel therapeutic strategies.
- Targeting angiogenesis, especially multiple pathways, offers a promising approach for NSCLC treatment.
- Further investigation through Phase III trials is required to establish the role of these novel agents in NSCLC management.
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