Combination of Bevacizumab and Dual Immunotherapy for Extensive-Disease Small-Cell Lung Cancer: A Case Report

Abstract

Small-cell lung cancer (SCLC) is sensitive to chemoradiotherapy but remains to have a poor prognosis. In the immunotherapy era, chemotherapy combined with PD-L1 inhibitors has become a new first-line treatment option for advanced SCLC. The CheckMate 032 study combined a PD-1 blockade and a CTLA-4 inhibitor and found that this dual immunotherapy might be a positive treatment choice for SCLC. In our case, the patient with advanced SCLC received bevacizumab combined with dual immunotherapy over the third line with more than 12 months survival time. The overall survival time was 21.5 months from the start of the third-line treatment and 39 months from the time of extensive-disease SCLC diagnosis. The combination of a VEGF blockade and a dual immunotherapy in SCLC resulted in synergistic treatment effects. Therefore, bevacizumab might be a better adjuvant, either combined with chemotherapy or dual immunotherapy, for patients with persistent disease progression after undergoing immunotherapy.

Inhibition of vascular endothelial growth factor‐A downregulates angiogenesis in psoriasis: A pilot study

“…The ability of VEGF‐A inhibition to downregulate pathological angiogenesis has been demonstrated in pre‐clinical studies of cancer and is well established 50–55 . Bevacizumab, which is currently used to downregulate angiogenesis in the treatment of metastatic colorectal cancer, 54–57 non‐squamous non‐small cell lung cancer 58,59 and hepatic cell carcinoma, 60 is used as a long‐term treatment and is often combined with chemotherapeutic agents 61–63 . To the best of our knowledge, we describe here the first studies to explore a potential therapeutic effect in inflammatory skin disease, demonstrating that VEGF‐A inhibition by bevacizumab exerts significant anti‐angiogenic activity in skin organ culture of psoriasis.…”

“… 50 , 51 , 52 , 53 , 54 , 55 Bevacizumab, which is currently used to downregulate angiogenesis in the treatment of metastatic colorectal cancer, 54 , 55 , 56 , 57 non‐squamous non‐small cell lung cancer 58 , 59 and hepatic cell carcinoma, 60 is used as a long‐term treatment and is often combined with chemotherapeutic agents. 61 , 62 , 63 To the best of our knowledge, we describe here the first studies to explore a potential therapeutic effect in inflammatory skin disease, demonstrating that VEGF‐A inhibition by bevacizumab exerts significant anti‐angiogenic activity in skin organ culture of psoriasis. Manifest by significant diminution in blood vessel area and blood vessel ECs in plaques of psoriasis, response to bevacizumab was significantly greater in patients with high levels of VEGF‐A in plasma/plaque skin and appeared to offer most treatment benefit to those with severe psoriasis.…”

Actionable Driver Events in Small Cell Lung Cancer

“…Finally, the combination of the VEGFR2 inhibitor apatinib with the immunotherapeutic agent camrelizumab has demonstrated anti-tumor activity in patients who previously failed platinum-based chemotherapy [144]. Similar results for extensivestage SCLC were achieved with the combination of the monoclonal antibody against VEGF bevacizumab and dual immunotherapy against PD-1 and CTLA-4 [145].…”