Antiangiogenic Therapy in First-Line Treatment of Advanced NSCLC: Advances in the Immunotherapy Era

Corresponding author: NING Fangling, ningfangling@126.com

DOI: 10.12201/bmr.202605.00079

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  Abstract: For patients with driver gene-negative advanced non-small cell lung cancer (NSCLC), immune checkpoint inhibitor therapy has become a core first-line treatment recommended by current clinical guidelines. Chemotherapy combined with immunotherapy has been established as the foundation of first-line therapy, marking the official entry of NSCLC treatment into the immunotherapy era. In this context, the value of anti-angiogenic therapy is not only reflected in directly inhibiting tumor growth but also in remodeling the tumor immune microenvironment and enhancing the delivery and efficacy of immunotherapy. This article first systematically elucidates the therapeutic basis of anti-angiogenic agents in advanced NSCLC from the perspectives of molecular mechanisms and cellular levels. Second, focusing on different target populations, it reviews multiple clinical studies evaluating the efficacy and safety of anti-angiogenic agents combined with immunotherapy and chemotherapy. Finally, it systematically summarizes the evidence-based rationale and clinical strategies for the application of anti-angiogenic agents (represented by bevacizumab) in first-line treatment of advanced NSCLC in China during the immunotherapy era, aiming to provide references for individualized clinical decision-making.

  Key words: anti-angiogenic agents; advanced non-small cell lung cancer (NSCLC); immune checkpoint inhibitors (ICIs); programmed death-ligand 1 (PD-L1)

  Submit time: 22 May 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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