The Impact of VEGF Inhibition on Clinical Outcomes in Patients With Advanced Non-Small Cell Lung Cancer Treated With Immunotherapy: A Retrospective Cohort Study.

anti-VEGF therapy immune checkpoint inhibitors immunotherapy non-small cell lung cancer treatment response

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2021
Historique:
received: 05 02 2021
accepted: 16 04 2021
entrez: 14 6 2021
pubmed: 15 6 2021
medline: 15 6 2021
Statut: epublish

Résumé

In recent years, immune checkpoint inhibitors (ICIs) in combination with chemotherapy have increased survival in patients with advanced non-small cell lung cancer (NSCLC). Vascular endothelial growth factor (VEGF), which plays a key role in tumor angiogenesis, is an immunological modulator; therefore, it is expected that anti-VEGF therapy in combination with ICIs enhances the antitumor effect of ICIs. In the present study, we investigated the impact of VEGF inhibition on clinical outcomes of NSCLC patients, including the efficacy of ICI treatment. A total of 105 patients with advanced NSCLC who had been treated with ICIs were retrospectively analyzed to examine the relationship between the history of treatment with anti-VEGF agents and the clinical outcomes with ICI monotherapy. Patients who had received anti-VEGF therapy prior to ICIs showed shortened progression-free survival of ICI treatment and a decreased overall response rate to ICI treatment. By contrast, anti-VEGF therapy after ICI treatment was associated with increased survival, especially in patients who had also received anti-VEGF therapy prior to ICI therapy. These retrospective observations suggest that anti-VEGF therapy prior to ICIs might be a negative predictor of response to ICIs. The sequence of anti-VEGF therapy might play a role in its ability to predict survival in NSCLC patients. Further investigation is warranted to identify the role of VEGF inhibition in altering clinical outcomes after immunotherapy.

Sections du résumé

BACKGROUND BACKGROUND
In recent years, immune checkpoint inhibitors (ICIs) in combination with chemotherapy have increased survival in patients with advanced non-small cell lung cancer (NSCLC). Vascular endothelial growth factor (VEGF), which plays a key role in tumor angiogenesis, is an immunological modulator; therefore, it is expected that anti-VEGF therapy in combination with ICIs enhances the antitumor effect of ICIs. In the present study, we investigated the impact of VEGF inhibition on clinical outcomes of NSCLC patients, including the efficacy of ICI treatment.
METHODS METHODS
A total of 105 patients with advanced NSCLC who had been treated with ICIs were retrospectively analyzed to examine the relationship between the history of treatment with anti-VEGF agents and the clinical outcomes with ICI monotherapy.
RESULTS RESULTS
Patients who had received anti-VEGF therapy prior to ICIs showed shortened progression-free survival of ICI treatment and a decreased overall response rate to ICI treatment. By contrast, anti-VEGF therapy after ICI treatment was associated with increased survival, especially in patients who had also received anti-VEGF therapy prior to ICI therapy.
CONCLUSIONS CONCLUSIONS
These retrospective observations suggest that anti-VEGF therapy prior to ICIs might be a negative predictor of response to ICIs. The sequence of anti-VEGF therapy might play a role in its ability to predict survival in NSCLC patients. Further investigation is warranted to identify the role of VEGF inhibition in altering clinical outcomes after immunotherapy.

Identifiants

pubmed: 34123822
doi: 10.3389/fonc.2021.663612
pmc: PMC8194394
doi:

Types de publication

Journal Article

Langues

eng

Pagination

663612

Informations de copyright

Copyright © 2021 Tanimura, Yamada, Omura, Shiotsu, Kataoka, Takeda, Taniguchi, Yamada, Takeuchi, Chihara, Morimoto, Iwasaku, Kaneko, Uchino and Takayama.

Déclaration de conflit d'intérêts

TadY received commercial research grants from Pfizer, Ono Pharmaceutical, Chugai Pharmaceutical, and Takeda Pharmaceutical Company Limited. JU received research grants from Eli Lilly Japan K.K., AstraZeneca K.K., and Boehringer Ingelheim Japan. KoT received research grants from Chugai-Roche and Ono Pharmaceutical and personal fees from AstraZeneca, Chugai-Roche, MSD-Merck, Eli Lilly, Boehringer Ingelheim, and Daiichi Sankyo. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

Oncogenesis. 2015 Jun 01;4:e153
pubmed: 26029827
Science. 2005 Jan 7;307(5706):58-62
pubmed: 15637262
N Engl J Med. 2015 Oct 22;373(17):1627-39
pubmed: 26412456
N Engl J Med. 2020 May 14;382(20):1894-1905
pubmed: 32402160
Nat Commun. 2016 Sep 01;7:12680
pubmed: 27580750
Cancer Immunol Res. 2014 Feb;2(2):127-32
pubmed: 24778276
Clin Cancer Res. 2016 Jun 15;22(12):2908-18
pubmed: 26787752
Clin Cancer Res. 2016 Oct 1;22(19):4848-4858
pubmed: 27169993
J Exp Med. 2015 Feb 9;212(2):139-48
pubmed: 25601652
J Immunother Cancer. 2017 Oct 17;5(1):82
pubmed: 29041991
N Engl J Med. 2018 Jun 14;378(24):2288-2301
pubmed: 29863955
N Engl J Med. 2021 Mar 4;384(9):829-841
pubmed: 33657295
N Engl J Med. 2017 Nov 16;377(20):1919-1929
pubmed: 28885881
Science. 2015 Apr 3;348(6230):124-8
pubmed: 25765070
JCI Insight. 2016 Jun 16;1(9):e85974
pubmed: 27699271
Cancer Res. 2013 Jan 15;73(2):539-49
pubmed: 23108136
Lancet. 2016 Apr 9;387(10027):1540-1550
pubmed: 26712084
N Engl J Med. 2006 Dec 14;355(24):2542-50
pubmed: 17167137
N Engl J Med. 2015 Jun 25;372(26):2509-20
pubmed: 26028255
CA Cancer J Clin. 2018 Nov;68(6):425-445
pubmed: 30285281
N Engl J Med. 2016 Nov 10;375(19):1823-1833
pubmed: 27718847
Thorac Cancer. 2019 Apr;10(4):775-781
pubmed: 30809973
Cell Death Discov. 2016 Oct 03;2:16025
pubmed: 27752361
Lancet. 2017 Jan 21;389(10066):255-265
pubmed: 27979383
Cancer Res. 2016 Mar 15;76(6):1381-90
pubmed: 26719539
Nat Commun. 2015 Dec 04;6:8792
pubmed: 26635184
J Immunol. 1998 Feb 1;160(3):1224-32
pubmed: 9570538
Cancer Res. 2013 May 15;73(10):2943-8
pubmed: 23440426
Cancer Immunol Res. 2016 Jul;4(7):563-8
pubmed: 27197067
N Engl J Med. 2015 Jul 9;373(2):123-35
pubmed: 26028407
Anticancer Res. 2019 Sep;39(9):4987-4993
pubmed: 31519605
Cancer Immunol Res. 2014 Jul;2(7):632-42
pubmed: 24838938
Transl Lung Cancer Res. 2019 Aug;8(4):450-460
pubmed: 31555518
Clin Cancer Res. 2015 Jun 1;21(11):2635-43
pubmed: 25680376
J Clin Oncol. 2010 Jul 1;28(19):3167-75
pubmed: 20516446

Auteurs

Keiko Tanimura (K)

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Tadaaki Yamada (T)

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Ayaka Omura (A)

Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.

Shinsuke Shiotsu (S)

Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.

Nobutaka Kataoka (N)

Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.

Takayuki Takeda (T)

Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.

Ryusuke Taniguchi (R)

Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan.

Takahiro Yamada (T)

Department of Pulmonary Medicine, Matsushita Memorial Hospital, Osaka, Japan.

Mayumi Takeuchi (M)

Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan.

Yusuke Chihara (Y)

Department of Respiratory Medicine, Uji-Tokushukai Medical Center, Kyoto, Japan.

Yoshie Morimoto (Y)

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Masahiro Iwasaku (M)

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Yoshiko Kaneko (Y)

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Junji Uchino (J)

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Koichi Takayama (K)

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Classifications MeSH