Using Antiangiogenic Therapy in NSCLC in the Future

H. Jack West, MD: We are entering into a new era. Immunotherapy is moving from very frequently used as a second-line or later treatment to increasingly used as either monotherapy or in combination with chemotherapy in the first-line setting. That is going to change the landscape for everything that will follow. We don’t have a lot of options for the patients who have already received chemotherapy and immunotherapy and have a good performance status. That has really just left us with docetaxel, alone, or in combination with ramucirumab.

I think that there will be more patients who are candidates for a combination, and I think that this work with ramucirumab, and the use of bevacizumab in some first-line trials, has reminded us of the potential benefits of antiangiogenic therapies that have been largely bypassed with all of the excitement regarding immunotherapy. The tidbits of positive results should remind us that there is still plenty to be gained by adding and better identifying the best way to integrate these therapies in combination—potentially with chemotherapy, immunotherapy, and with targeted therapies. This may be considered as last year’s model because people have been chasing immunotherapy for the last few years. We have not mined the potential benefits of antiangiogenic therapies as well as we can. I hope and expect to see more clinical trial data that will translate to us actually being able to better utilize these therapies in combinations that deliver an improvement in overall survival for our patients in various lines and settings.