Preliminary considerations on the use of nintedanib (BIBF 1120) in lung cancer patients

摘要: Angiogenesis is a crucial mechanism for growth, proliferation and metastasis in many tumor types including lung cancer [1]. The VEGF ligand plays key role regulation, both normal cells, promoting endothelial cell migration necessary angiogenesis. overexpressed majority of malignant tumors, non-small-cell (NSCLC), elevated blood levels are associated with aggressiveness poor prognosis [2]. Thus, it was logical that inhibiting abnormal vessel formation we can induce an antitumor effect [3]. There agents demonstrate anti angiogenic properties but unfortunately, years, only bevacizumab (a monoclonal antibody against ligand) has shown consistent efficacy several types; however, cells inhibited by escape from its upregulating other proangiogenic molecules such as PDGF FGF. Hence, ongoing research focused on developing novel inhibit multiple signaling pathways angiogenesis [4–7]. concept multi targeted tyrosine kinase inhibitors (TKIs) significantly important because allows us to block receptors the decrease their chance resistance and, at same time, keep selected tolerable toxicity profile. Unfortunately, cancer, all these multitargeted TKIs have controversial results. As example, sorafenib which approved treatment renal carcinoma hepatocellular [8,9] studied cancer. Two Phase III trials first-line chemotherapy NSCLC (paclitaxel/carboplatin ESCAPE gemcitabine/cisplatin NExUS) alone or combination failed overall survival (OS) benefit arms [10,11]. Sunitinib, another oral small molecule inhibitor receptor (VEGFR), (PDGFR), c-Kit Flt-3, approval indications gastrointestinal stromal [12,13]. II data suggested sunitinib single-agent activity previously treated advanced patients response