Clinical relevance of monoclonal antibodies in non small cell lung cancer.
Targeted therapies with monoclonal antibodies have been shown to improve the outcome of non-small cell lung cancer (NSCLC). Current strategies focus on the blockade of growth factor receptors and the inhibition of angiogenesis. Epidermal growth factor receptor (EGFR)-directed monoclonal antibodies in combination with platinum-based first-line chemotherapy have shown promising efficacy in phase II trials. In a phase III trial, cetuximab combined with cisplatin/ vinorelbine resulted in superior survival compared to chemotherapy alone in patients with advanced EGFR-positive NSCLC. Inhibition of angiogenesis has also been successfully applied as a new treatment strategy. Bevacizumab added to palliative chemotherapy has improved progression-free survival in two phase III trials and overall survival in one of these trials in selected patients with advanced non-squamous cell lung cancer. Bevacizumab is now approved for selected patients with advanced NSCLC in combination with platinum-based chemotherapy. Figitumumab is a monoclonal antibody against the insulin-like growth factor-1 receptor (IGF-1R) which demonstrated activity in preclinical models of NSCLC and in a phase II trial. Because of these promising results, three randomized, open-label, international phase III trials of figitumumab in patients with locally advanced or metastatic NSCLC are in progress.
Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria. martin.filipits@meduniwien.ac.at
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D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000276:immunology; D066246:ErbB Receptors / Q000276:immunology; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000276:immunology; D017526:Receptor, IGF Type 1 / Q000276:immunology; D040262:Receptors, Vascular Endothelial Growth Factor / Q000276:immunology
D000911:Antibodies, Monoclonal; D066246:ErbB Receptors; D017526:Receptor, IGF Type 1; D040262:Receptors, Vascular Endothelial Growth Factor