From the Director and Professor, James Dudley Chair in Cancer Research, University of Colorado Cancer Center, Aurora, CO; Associate Professor in Oncology and Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Associate Professor, M. D. Anderson Cancer Center, Houston, TX
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Paul A. Bunn, Jr., MD, University of Colorado Cancer Center, 13001 E. 17th Place, Ste. C 6004, Aurora, CO 80045
Overview: Recent studies with bevacizumab and other agents have validated tumor vasculature as a therapeutic target in non-small cell lung cancer, but the gains thus far have been relatively modest. To date, most of these approaches have focused on targeting the vascular endothelial growth factor (VEGF) pathway using antibodies or small molecular tyrosine kinase inhibitors (TKIs). Given the wealth and diversity of antiangiogenic agents, particularly agents targeting the VEGF pathway under evaluation, and the multitude of receptor TKIs in or entering phase III evaluation, it appears likely that there will be a choice of multiple agents targeting the VEGF pathway in the near future. Identifying markers for selecting patients who are likely to benefit from a given drug or excluding those more likely to experience toxicity; investigating the mechanisms by which tumors developing therapeutic resistance to these agents, and developing effective means for combating it; and using our growing knowledge of tumor angiogenesis and the availability of different classes of drugs targeting tumor vasculature to develop rational and effective combination regimens are major challenges facing the field.
