【2022 ESMO】The prospect of recombinant human vascular endostatin combined with immunological first-line treatment of non-small cell lung cancer is promising

On September 9~13, 2022, the Congress of the European Society of Medical Oncology (ESMO) was held
simultaneously online and offline in Paris, France.
As Europe's prestigious and influential oncology conference, ESMO Congress attracts the attention of oncology professionals worldwide
.
At the ESMO conference, a variety of innovative therapies in the field of lung cancer were unveiled, and one of the research data on recombinant human angioendostatin combined with immunological first-line treatment of advanced non-small cell lung cancer (NSCLC) was dazzling and selected for poster display.

Figure 1 ESMO 2022 conference

Figure 2 Experts and scholars speak at the ESMO conference

Figure 3 Summary number 1042P poster display

Recombinant human vascular endostatin plays an important role in the treatment of NSCLC

Lung cancer is one of the most common malignancies, with morbidity and mortality among all cancer types
.
Among them, more than 80% of lung cancer pathological types are NSCLC ^[1].

With the advancement of medicine, the treatment of advanced NSCLC has made great progress in the past decade, and antiangiogenic drugs have become an important therapeutic weapon
for advanced NSCLC.

Recombinant human angioendostatin is the first anti-angiogenesis-targeted drug independently developed in China, and its efficacy and safety in the treatment of NSCLC have been confirmed by many clinical trials, so it is recommended by authoritative guidelines and consensus for the first-line treatment
of advanced NSCLC.
CSCO guidelines and expert consensus both point out that for patients with advanced NSCLC with negative driver gene mutations and PS 0~1 points, recombinant human vascular endothelial inhibin combined with vinorelbine and cisplatin can be used first-line treatment ^[2,3].

Recombinant human angioendostatin works synergistically with immunity

In the era of immunotherapy, recombinant human angioendostatin plays an important role
in immunotherapy.
Recombinant human angioendostatin can induce the normalization of tumor blood vessels, improve the tumor immune microenvironment, promote the infiltration of CD8+ T cells into tumors, reduce the number of myeloid suppressor cells and M2 tumor-associated macrophages in tumor tissues, increase the number of myeloid dendritic cells and M1 tumor-associated macrophages that promote immunity in tumor tissues, and improve the microenvironment of suppressing immunity in tumors to the microenvironment of promoting immunity^[4], This coincides with the idea that immunotherapy is committed to modifying the tumor microenvironment
.

In addition, preclinical data show that recombinant human angioendostatin combined with PD-1 monoclonal antibody therapy significantly slows down tumor growth, effectively improves tumor microenvironment, and has obvious synergistic antitumor effects ^[5], which makes antiangiogenic drugs combined with immunotherapy a hot research direction
.

The efficacy and safety of recombinant human vascular endostatin combined with immunological first-line treatment of NSCLC are good

The ESMO conference on the efficacy and safety of immune checkpoint inhibitors combined with recombinant human angioendostatin in the first-line treatment of advanced NSCLC was retrospectively analyzed, of which 58 patients in the experimental group (IEC group) were treated with PD-1 inhibitors combined with recombinant human angioendostatin and chemotherapy, and 42 patients in the control group (EC group) were treated with recombinant human angioendostatin and chemotherapy
。 The primary endpoint of the study was progression-free survival (PFS), with secondary endpoints including objective response rate (ORR), disease control rate (DCR), and comparison
of adverse events between IEC and EC groups.

The results showed that PFS was significantly longer in the IEC group (10.
2 versus 6.
5 months, P < 0.
001), ORR was significantly improved (67.
2 versus 42.
9 percent, P = 0.
015), and disease control and 1-year overall survival were higher in the IEC group than in the control group (disease control rate: 98.
3 versus 90.
5 percent, P = 0.
193; 1-year overall survival: 79.
3 versus 76.
2 percent, P = 0.
710).

。 Cox multivariate regression analysis suggests that modality, brain metastases, and clinical staging may be independent risk factors
for median PFS.
In terms of safety, there was no significant difference in
the incidence of adverse events between the two groups.
This study demonstrated that PD-1 inhibitors combined with recombinant human angioendostatin can significantly increase ORR and PFS in the first-line treatment of advanced NSCLC, providing a promising treatment option
for such patients.

Figure 4 mPFS of IEC group and EC group

summary

The treatment of advanced NSCLC is developing rapidly, and it is also full of opportunities and challenges
.
Based on the synergistic mechanism of antiangiogenic drugs and immunotherapy drugs, recombinant human angioendostatin combined with immunofirst-line treatment of advanced NSCLC showed promising application prospects and overall safety
profile.
In the future, it is expected that domestic recombinant human angioendostatin combined with immunity/targeting and other treatment modes will open a new pattern of treatment of domestic innovative drugs and bring more benefits to patients!

Click here to download the study poster!

References:

1.
Su Chunxia, et al.
China Oncology, 2022, 32(6):9.

2.
CSCO Guidelines for the Diagnosis and Treatment of Non-Small Cell Lung Cancer, 2022.

3.
Expert Committee of Vascular Targeted Therapy of Chinese Society of Clinical Oncology, et al.
Chinese Journal of Oncology, 2020, 42(12): 1063-1077.

4.
Liu XL, et al.
Oncology Letters, 2018, 15(2):1874-1880.

5.
JIANG Yunfeng, et al.
Journal of Shandong University (Health Sciences), 2018, 56(9):11-16.

6.
H.
Huang, et al.
2022 ESMO.
Abstract 1042P.