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The Oncologist, Vol. 12, No. 10, 1183-1193, October 2007; doi:10.1634/theoncologist.12-10-1183
© 2007 AlphaMed Press

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 The Role of Bevacizumab in the Treatment of Non-Small Cell Lung Cancer: Cur...
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Lung Cancer

The Role of Bevacizumab in the Treatment of Non-Small Cell Lung Cancer: Current Indications and Future Developments

Cesare Gridellia, Paolo Maionea, Antonio Rossia, Filippo De Marinisb

aDivision of Medical Oncology, "S.G. Moscati" Hospital, Avellino, Italy; bI Division of Oncological Pneumology, Department of Lung Diseases, San Camillo-Forlanini Hospitals, Roma, Italy

Key Words. Bevacizumab • NSCLC • Angiogenesis • Targeted therapy

Correspondence: Cesare Gridelli, M.D., Division of Medical Oncology, "S.G. Moscati" Hospital, Contrada Amoretta, 83100 Avellino, Italy. Telephone: 39-0825-203573; Fax: 39-0825-203556; e-mail: cgridelli{at}libero.it

Disclosure: C.G. and F.DeM. have acted as consultants to and have financial interests in Roche. No other potential conflicts of interest were reported by the authors, planners, reviewers, or staff managers of this article.

The majority of non-small cell lung cancer (NSCLC) patients present with advanced disease, and despite the improvement in efficacy and safety outcomes with platinum-based chemotherapy, this standard cytotoxic approach has reached a therapeutic plateau, with the prognosis for this clinical condition remaining poor. Advances in the knowledge of tumor biology and mechanisms of oncogenesis have granted the singling out of several molecular targets for NSCLC treatment. Bevacizumab, an anti–growth factor vascular endothelial growth factor (VEGF) monoclonal antibody, is the antiangiogenic agent at the most advanced stage of development in the treatment of solid tumors and also in NSCLC treatment. Bevacizumab, combined with platinum-based chemotherapy, has been demonstrated to improve efficacy outcomes over chemotherapy alone in the treatment of nonsquamous advanced NSCLC in two phase III randomized trials. These represent the first evidence of improvement in treatment outcomes of chemotherapy with targeted therapies in the first-line treatment of advanced NSCLC. Future clinical developments of bevacizumab in NSCLC treatment will include the combination of this agent with other targeted therapies in advanced disease (especially with erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor) and the integration of this agent into combined modality approaches for the treatment of early-stage and locally advanced disease.






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