Bevacizumab and non-small-cell lung cancer: starving the enemy to survive.
Although platinum-based chemotherapy remains a mainstay of non-small-cell lung cancer treatment, its efficacy has probably reached a plateau. Increased understanding of cancer biology has allowed the identification of a number of possible molecular targets, including the EGF receptor and the angiogenesis pathway. ECOG-E4599 has randomised chemonaive patients to receive paclitaxel--carboplatin with and without bevacizumab, a humanised monoclonal antibody targeting the VEGF. The study is the first to show a survival advantage of adding a biological agent to chemotherapy in this setting: in particular, for the first time the survival of lung cancer patients has been extended beyond 1 year. The aim of this review is to describe the biological and clinical properties of bevacizumab and to discuss the evidence that has supported its approval for the first-line treatment of advanced non-squamous non-small-cell lung cancer.
Medical Oncology A, Disease Management Team, Lung Cancer, National Institute for Cancer Research, Largo Rosanna Benzi, Genova, Italy. francesco.grossi@istge.it
Francesco
F
Grossi
Marianna
M
Aita
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D011358:Product Surveillance, Postmarketing
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab