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New Agents in Development
A number of new antiangiogenic agents are in development for NSCLC. One of these, called motesanib, was tested in a randomized phase 3 trial called MONET1.8 Although this agent did not improve overall survival compared with placebo, there was an improvement in PFS and overall response. Another investigational agent, called aflibercept (VEGF Trap), acts as a decoy receptor for VEGF. By attaching itself to VEGF, aflibercept prevents the protein from binding to receptors on blood vessel cells and stimulating angiogenesis.9 Aflibercept is being evaluated in a phase 3 clinical study in combination with chemotherapy in NSCLC patients who have relapsed or had their cancer progress on front-line chemotherapy.10

Two of the newer investigational antiangiogenic agents for advanced NSCLC are ramucirumab (IMC-1121B), an antibody therapy against VEGF-receptor-2, and BIBF 1120, an orally administered angiogenesis inhibitor. Preliminary results from a phase 2 study of ramucirumab showed that 10 of 15 lung cancer patients (67%) who received this drug had their tumors shrink.11 A phase 3 trial of ramucirumab in advanced NSCLC is enrolling patients.12 In this trial, NSCLC patients will be randomly assigned to treatment with the chemotherapy drug docetaxel, either with or without ramucirumab. BIBF 1120 is being evaluated in two phase 3 clinical trials in advanced NSCLC, one trial in combination with docetaxel and the second in combination with pemtrexed.13 Both studies are in patients who have relapsed or progressed on front-line therapy.


Last updated July 15, 2011