Traitements anti-angiogéniques en pratique et dans le futur en oncologie thoracique

Many growth factors involved in tumor angiogenesis are potential targets in nonsmall cell lung cancer (NSCLC), small cell lung cancer (SCLC) and malignant pleural mesothelioma (MM). Currently, bevacizumab is the only drug that demonstrated an impact on overall survival in first line treatment for stage IV non-squamous NSCLC, but VEGFR-TKI such as cediranib, aflibercept, vandetanib, pazopanib showed encouraging results in phase II or III clinical trials. In extensive-disease SCLC and inoperable mm, bevacizumab is the most studied molecule, but again, clinical trials are ongoing. Current data on potential predictors for efficacy are disappointing, but some biomarkers or radiological techniques might be useful for guiding the use of anti-angiogenic therapy in the future.