![]() Antiangiogenic therapy can normalize the blood vessels in this part of the tumour, weaken the suppression of immune factors, and thus promote the development of immunotherapy, which is beneficial for the application of immunotherapy. Tumour vascular normalization and immune reprogramming form a reinforcing loop that reconditions the tumour immune microenvironment to induce durable antitumour immunity. How to obtain the dominant population of immunotherapy and improve the efficacy of immunotherapy is a hot topic in clinical research.Īntiangiogenic drugs, including monoclonal antibodies targeting vascular endothelial growth factor (VEGF) or VEGF receptors (VEGFRs), such as bevacizumab, and small-molecule tyrosine kinase inhibitors (TKIs) targeting multiple angiogenic pathways, such as anlotinib and apatinib, have shown antitumour effects in NSCLC.Ī preclinical study revealed that tumour angiogenesis is closely related to the immune microenvironment. However, the overall effective rate of ICI monotherapy in NSCLC is only 20%. Especially for advanced NSCLC patients without targetable driver oncogenes, immune checkpoint inhibitors (ICIs) provide new therapeutic options with longer progression-free survival (PFS) and overall survival (OS). Targeted therapy and immunotherapy for different molecular types have greatly improved the prognosis of patients. In recent years, with the continuous progress of molecular biology technology, NSCLC has been increasingly identified as a highly heterogeneous disease. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancers. Lung cancer is still the most common malignant tumour with morbidity and mortality in China and seriously threatens the life and health of Chinese people. PD-L1 expression was a potential predictor of response for immunotherapy combined with antiangiogenic therapy. Bone metastases were a potential independent negative predictor of OS. ![]() Brain metastases and bone metastases were potentially independent negative predictors of PFS. Immunotherapy combined with antiangiogenic therapy was an option for advanced NSCLC patients with good safety and tolerability. AEs of different grades occurred in 92.9% (79/85) of NSCLC patients, most of which were mild grade 1/2 AEs. Furthermore, PD-L1 expression was associated with treatment responses in advanced NSCLC (χ2 = 22.123, p = 0.000). Patients with EGFR mutations who received combination therapy had worse OS than those with KRAS mutations ( p = 0.026). In addition, patients receiving immunotherapy combined with antiangiogenic therapy in second-line therapy had longer OS than those receiving immunotherapy in third- or later-line therapy ( p = 0.039). NSCLC patients with brain metastasis ( p = 0.025), liver metastasis ( p = 0.012), bone metastasis ( p = 0.014) and EGFR mutations ( p = 0.033) had shorter OS. Subgroup analysis revealed that NSCLC patients with stage IV ( p = 0.042), brain metastasis ( p = 0.016) and bone metastasis ( p = 0.016) had shorter PFS. The objective response rate and disease control rate were 32.9% and 83.5%, respectively. The patients had a median progression-free survival (PFS) of 7.9 months and a median overall survival (OS) of 18.60 months. ResultsĪ total of 85 advanced NSCLC patients were enrolled. Methodsĭata on clinicopathological features, efficacy and adverse events (AEs) were collected retrospectively in advanced NSCLC patients who received immunotherapy combined with antiangiogenic therapy. ![]() This study was performed to investigate the efficacy and safety of combined immunotherapy and antiangiogenic therapy for advanced non-small cell lung cancer (NSCLC) in the real world.
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