First-line chemotherapy plus immune checkpoint inhibitors or bevacizumab in advanced non-squamous non-small-cell lung cancer without EGFR mutations or ALK fusions

Analysis of the Effects of Bevacizumab Combined with Chemoradiotherapy on VEGF, bFGF, and Let-7 Levels in Non-Small Cell Lung Cancer and the Factors Influencing Therapeutic Efficacy: A Retrospective Cohort Study

Objective

To explore the influence of bevacizumab combined with chemoradiotherapy on VEGF, bFGF, and Let-7 in patients with non-small cell lung cancer (NSCLC), and to analyze the factors affecting its efficacy.

Methods

Totally 150 patients with non-small cell lung cancer (NSCLC) treated in our hospital from November 2018 to November 2023 were retrospectively analyzed. The serum levels of VEGF, bFGF, and Let-7 were collected and compared. Patients were divided into good efficacy and poor efficacy groups based on short-term efficacy, and logistic regression analysis was used to analyze the factors affecting efficacy.

Results

Before treatment, there was no significant difference in the levels of VEGF, bFGF, and Let-7 between the two groups (P>0.05). After treatment, the levels of VEGF, bFGF, and Let-7 in both groups improved compared to before treatment, and compared with the control group, the study group had lower levels of VEGF and bFGF, and higher levels of Let-7, with statistically significant differences (all P<0.05). Multifactorial logistic regression analysis revealed that the course of disease, tumor diameter, and treatment regimen were independent factors influencing the therapeutic efficacy of NSCLC (all P<0.05).

Conclusion

For patients with NSCLC, the treatment regimen of bevacizumab combined with chemoradiotherapy can achieve better efficacy, with a higher objective response rate, effectively reduce the level of vascular endothelial growth factor, increase Let-7 level, and ensure safety. In addition, disease course, tumor diameter, and treatment regimen are independent factors affecting the efficacy of NSCLC. Therefore, these factors should be comprehensively considered when formulating treatment plans to ensure the best therapeutic effect.

Bevacizumab/PD-1 inhibitor plus chemotherapy as first-line treatment of advanced non-squamous non-small-cell lung cancer

Aim: To compare the effectiveness of PD-1 inhibitor or bevacizumab plus chemotherapy in advanced non-squamous non-small cell lung cancer (nsNSCLC). Methods: We retrospectively collected data for patients with advanced nsNSCLC who underwent first-line treatment with PD-1 inhibitor or bevacizumab plus chemotherapy (IC and BC groups). Propensity score matching (PSM) was adopted to balance covariates. Results: 278 patients were enrolled, after PSM (n = 104/group), the objective response rate was 45.1% and 24.0% in the IC and BC groups (p = 0.001). Median progression-free survival (PFS) was 13.5 and 8.2 months (p = 0.007), and duration of response was 14.8 versus 8.1 months (p = 0.007), respectively. In subgroup analysis, the PFS for those patients with PD-L1≥1% (16.2 vs 6.8 months, p = 0.000) was significantly longer in the IC group than that in BC group, but not in the PD-L1<1% subgroup (8.9 vs12.7 months, p = 0.719). Conclusion: PD-1 inhibitor plus chemotherapy was superior to bevacizumab plus chemotherapy as first-line treatment for advanced nsNSCLC, which is debatable for patients with PD-L1<1%.

Ginsenosides: Allies of gastrointestinal tumor immunotherapy

In the past decade, immunotherapy has been the most promising treatment for gastrointestinal tumors. But the low response rate and drug resistance remain major concerns. It is therefore imperative to develop adjuvant therapies to increase the effectiveness of immunotherapy and prevent drug resistance. Ginseng has been used in Traditional Chinese medicine as a natural immune booster for thousands of years. The active components of ginseng, ginsenosides, have played an essential role in tumor treatment for decades and are candidates for anti-tumor adjuvant therapy. They are hypothesized to cooperate with immunotherapy drugs to improve the curative effect and reduce tumor resistance and adverse reactions. This review summarizes the research into the use of ginsenosides in immunotherapy of gastrointestinal tumors and discusses potential future applications.