Title:Anti-Angiogenic Drugs and Biomarkers in Non-Small-Cell Lung Cancer: 'A Hard Days Night'
VOLUME: 20 ISSUE: 24
Author(s):Sara Pilotto, Maria Bonomi, Francesco Massari, Michele Milella, Ludovica Ciuffreda, Matteo Brunelli, Matteo Fassan, Marco Chilosi, Aldo Scarpa, Giampaolo Tortora and Emilio Bria
Affiliation:Medical Oncology dU, Policlinico ‘G.B. Rossi’, University of Verona, P.zza L.A. Scuro 1, 37134, Verona, Italy.
Keywords:Angiogenesis, lung cancer, review.
Abstract:The discovery of specific molecular alterations (i.e. EGFR activating mutations, EML4/ALK translocation, ROS1 rearrangements)
in a selected population of patients affected by non small cell lung cancer (NSCLC) translated into effective treatments for this
small but well defined fraction of patients, driven by the use of predictive biomarkers of efficacy for targeted agents. Unfortunately, the
same reliable predictive biomarkers are lacking for anti-angiogenic drugs. Angiogenesis plays a major role in the progression of NSCLC,
however, anti-angiogenic agents provided a minimal, although significant, clinical benefit in unselected populations, burdened by a not
negligible toxicities. In this context, no validated angiogenic factor or other molecular biomarker of angiogenesis can reliably predict
clinical outcome, sensitivity, early response or resistance to any of the investigated anti-angiogenic therapies currently used. Moreover,
the available clinical data are prevalently retrospective, underpowered, and, in many cases, contradictory, thus underscoring that the understanding
of the complex architecture of angiogenic signaling is still incomplete. We here review the currently available studies on the
effect of anti-angiogenic drugs in NSCLC, with a particular focus on bio-molecular factors that are regarded as potential predictors of
treatment efficacy.
