ONCAlert | 2017 San Antonio Breast Cancer Symposium
Lung Cancer Case Studies

Mark Kris, MD: Antiangiogenic Therapy in NSCLC

Mark Kris, MD
Published Online:Apr 27, 2016
RP is a 72 year old whose past medical history is notable for hypertension (well-controlled), hyperuricemia, and gout. He presents to his PCP with fatigue, progressive dyspnea, and a persistent, nonproductive cough of approximately 1 month's duration. He is a former smoker and quit approximately 30 years ago.

mNSCLC with Mark Kris, MD and Mark Socinski, MD: Case 1



What clinical benefit do you achieve using an antiangiogenic therapy in this patient type that you don’t achieve with chemotherapy alone?

So there have been a number of clinical trials adding an antiangiogenic therapy in initial therapy. And the therapy that’s been added ahs been bevacizumab. The largest clinical trial was done here in the United States, and that trial showed that by adding bevacizumab to standard chemotherapy in a randomized trial, the patients had an improvement in response, almost a doubling in rates of response which of course translates into symptom improvement for patients that have symptoms, an improvement in the time to disease progression, and also improvement in overall survival. So I’ll call it the trifecta of benefit was shown in the trial. In a fit patient, I would always add bevacizumab to the standard chemotherapy. 

mNSCLC: Case 1

RP is a 72 year old whose past medical history is notable for hypertension (well-controlled), hyperuricemia, and gout. He presents to his PCP with fatigue, progressive dyspnea, and a persistent, nonproductive cough of approximately 1 month’s duration. He is a former smoker and quit approximately 30 years ago.

  • Chest X-ray in October 2015 showed a large mass in the upper left lobe and CT scan showed a left pleural effusion and enlargement of the left mediastinal and hilar lymph node.
  • MRI of the brain was negative for intracranial metastases.
  • The patient underwent resection of the primary mass which showed large cell carcinoma. Pleural fluid was tapped and also positive.
  • His lung cancer was staged as 4. His biopsy was sent for molecular testing and showed no actionable mutations in EGFR or ALK.
  • His current performance status is 1.
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