English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Antibody against vascular endothelial growth factor ligand (anti-VEGF) or receptor (anti-VEGFR) and antibody against programmed death-1 (anti-PD-1) receptor or programmed death ligand 1 (anti-PD-L1) are often not combined to treat patients with advanced malignancies. Recent proposals have postulated that such a combination could produce synergistic effect thus providing greater clinical advantage than realized otherwise (1). Herbst et al. recently reported an anti-VEGFR and anti-PD-1 combination for three advanced solid tumor cohorts: gastroesophageal adenocarcinoma (GEA), non-small cell lung cancer (NSCLC), and urothelial carcinoma (UC) (2). Such patients have considerable unmet needs and novel approaches are needed (3-5). Currently, ramucirumab, anti-VEGFR, has been approved to treat advanced GEA and NSCLC patients in the second line setting but it produces minimum advantage (6,7). Ramucirumab’s limited role in NSCLC patients has been criticized (8). In GEA patients, the combination of paclitaxel and ramucirumab is the preferred regimen (3) over marginal effects of ramucirumab alone (3,6,9). The checkpoint inhibition (IO) immunotherapy with pembrolizumab was approved for 3 or later line therapy of advanced GEA patients based solely on the response rate but 4 randomized studies have failed to produce survival benefit from IO (3,10-13). Thus we can say with certainty that advanced GEA is barely responsive to IO and most patients have an evidence of cancer progression at the time of first response assessment. However, the scenario is quite different for NSCLC and UC where IO therapy has made considerable impact in patient outcome (14-18). The role of IO therapy in advanced NSCLC depends on the absence of the targetable driver mutations (4). Patients with tumors without these driver mutations are candidates for anti-PD-1 or antiPD-L1 therapy alone or in combination with platinum doublet chemotherapy. Anti-PD-1 therapy preference for monotherapy vs combination with chemotherapy is dependent on the level (labeling index) of PD-L1 expression. Pembrolizumab monotherapy is preferred for those with PD-L1 expression ≥50% while using pembrolizumab in combination with platinum doublet therapy is for those with PD-L1 1–49%. Responses seen in KEYNOTE-024 were approximately 45% with pembrolizumab and a clear advantage over platinum doublet chemotherapy (4 months improvement in PFS) in this group (17). Subsequent therapy options for those that did not receive an anti-PD-1 or anti-PD-L1 agent in the front-line may receive one of these options depending on specific indication (4). Interesting to note, bevacizumab has been studied in combination with atezolizumab plus chemotherapy (ABCP regimen) compared to bevacizumab Editorial Commentary

chinese clinical oncology

The role of ramucirumab and pembrolizumab combination in patients with advanced non-small cell lung cancer, gastroesophageal adenocarcinoma, or urothelial carcinoma