Bevacizumab in the treatment of NSCLC: patient selection and perspectives

Alessia E Russo,1 Domenico Priolo,1 Giovanna Antonelli,1 Massimo Libra,2 James A McCubrey,3 Francesco Ferraù1 1Medical Oncology Department, San Vincenzo Hospital, Taormina (Messina), Italy; 2Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and B...

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Autores principales:	Russo AE, Priolo D, Antonelli G, Libra M, Mccubrey JA, Ferraù F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	bevacizumab non-squamous NSCLC eligibility safety subpopulations Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/2a66d4dedbe34532a248193ff955aadc
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spelling	oai:doaj.org-article:2a66d4dedbe34532a248193ff955aadc2021-12-02T04:33:12ZBevacizumab in the treatment of NSCLC: patient selection and perspectives1179-2728https://doaj.org/article/2a66d4dedbe34532a248193ff955aadc2017-12-01T00:00:00Zhttps://www.dovepress.com/bevacizumab-in-the-treatment-of-nsclc-patient-selection-and-perspectiv-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Alessia E Russo,1 Domenico Priolo,1 Giovanna Antonelli,1 Massimo Libra,2 James A McCubrey,3 Francesco Ferraù1 1Medical Oncology Department, San Vincenzo Hospital, Taormina (Messina), Italy; 2Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; 3Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University, Greenville, NC, USA Abstract: Non-small-cell lung cancer (NSCLC) represents about 85% of all lung cancers, and more than half of NSCLCs are diagnosed at an advanced stage. Chemotherapy has reached a plateau in the overall survival curve of about 10 months. Therefore, in last decade novel targeted approaches have been developed to extend survival of these patients, including antiangiogenic treatment. Vascular endothelial growth factor (VEGF) signaling pathway plays a dominant role in stimulating angiogenesis, which is the main process promoting tumor growth and metastasis. Bevacizumab (bev; Avastin®) is a recombinant humanized monoclonal antibody that neutralizes VEGF’s biologic activity through a steric blocking of its binding with VEGF receptor. Currently, bev is the only antiangiogenic agent approved for the first-line treatment of advanced or recurrent nonsquamous NSCLC in “bev-eligible” patients. The ineligibility to receive bev is related to its toxicity. In the pivotal trials of bev in NSCLC, fatal bleeding events including pulmonary hemorrhage were observed with rates higher in the chemotherapy-plus-bev group. Therefore, in order to reduce the incidence of severe pulmonary hemorrhage, numerous exclusion criteria have been characteristically applied for bev such as central tumor localization or tumor cavitation, use of anticoagulant therapy, presence of brain metastases, age of patients (elderly). Subsequent studies designed to evaluate the safety of bev have demonstrated that this agent is safe and well tolerated even in those patients subpopulations excluded from pivotal trials. This review outlines the current state-of-the-art on bev use in advanced NSCLC. It also describes patient selection and future perspectives on this antiangiogenic agent. Keywords: bevacizumab, nonsquamous NSCLC, eligibility, safety, subpopulations Russo AEPriolo DAntonelli GLibra MMccubrey JAFerraù FDove Medical Pressarticlebevacizumabnon-squamous NSCLCeligibilitysafetysubpopulationsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 8, Pp 259-269 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	bevacizumab non-squamous NSCLC eligibility safety subpopulations Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	bevacizumab non-squamous NSCLC eligibility safety subpopulations Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Russo AE Priolo D Antonelli G Libra M Mccubrey JA Ferraù F Bevacizumab in the treatment of NSCLC: patient selection and perspectives
description	Alessia E Russo,1 Domenico Priolo,1 Giovanna Antonelli,1 Massimo Libra,2 James A McCubrey,3 Francesco Ferraù1 1Medical Oncology Department, San Vincenzo Hospital, Taormina (Messina), Italy; 2Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; 3Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University, Greenville, NC, USA Abstract: Non-small-cell lung cancer (NSCLC) represents about 85% of all lung cancers, and more than half of NSCLCs are diagnosed at an advanced stage. Chemotherapy has reached a plateau in the overall survival curve of about 10 months. Therefore, in last decade novel targeted approaches have been developed to extend survival of these patients, including antiangiogenic treatment. Vascular endothelial growth factor (VEGF) signaling pathway plays a dominant role in stimulating angiogenesis, which is the main process promoting tumor growth and metastasis. Bevacizumab (bev; Avastin®) is a recombinant humanized monoclonal antibody that neutralizes VEGF’s biologic activity through a steric blocking of its binding with VEGF receptor. Currently, bev is the only antiangiogenic agent approved for the first-line treatment of advanced or recurrent nonsquamous NSCLC in “bev-eligible” patients. The ineligibility to receive bev is related to its toxicity. In the pivotal trials of bev in NSCLC, fatal bleeding events including pulmonary hemorrhage were observed with rates higher in the chemotherapy-plus-bev group. Therefore, in order to reduce the incidence of severe pulmonary hemorrhage, numerous exclusion criteria have been characteristically applied for bev such as central tumor localization or tumor cavitation, use of anticoagulant therapy, presence of brain metastases, age of patients (elderly). Subsequent studies designed to evaluate the safety of bev have demonstrated that this agent is safe and well tolerated even in those patients subpopulations excluded from pivotal trials. This review outlines the current state-of-the-art on bev use in advanced NSCLC. It also describes patient selection and future perspectives on this antiangiogenic agent. Keywords: bevacizumab, nonsquamous NSCLC, eligibility, safety, subpopulations
format	article
author	Russo AE Priolo D Antonelli G Libra M Mccubrey JA Ferraù F
author_facet	Russo AE Priolo D Antonelli G Libra M Mccubrey JA Ferraù F
author_sort	Russo AE
title	Bevacizumab in the treatment of NSCLC: patient selection and perspectives
title_short	Bevacizumab in the treatment of NSCLC: patient selection and perspectives
title_full	Bevacizumab in the treatment of NSCLC: patient selection and perspectives
title_fullStr	Bevacizumab in the treatment of NSCLC: patient selection and perspectives
title_full_unstemmed	Bevacizumab in the treatment of NSCLC: patient selection and perspectives
title_sort	bevacizumab in the treatment of nsclc: patient selection and perspectives
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/2a66d4dedbe34532a248193ff955aadc
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Bevacizumab in the treatment of NSCLC: patient selection and perspectives

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