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Combinations of Bevacizumab With Cancer Immunotherapy

Chen, Daniel S., MD, PhD; Hurwitz, Herbert, MD

doi: 10.1097/PPO.0000000000000327
Review Articles

Cancer immunotherapy (CIT) has transformed cancer treatment. In particular, immunotherapies targeting the programmed death ligand 1 (PD-L1)/programmed death 1 pathway have demonstrated durable clinical benefit in some patients. However, CIT combinations may create a more favorable environment in which to maximize the potential of the immune system to eliminate cancer. Here we describe 3 key mechanisms related to vascular endothelial growth factor (VEGF)–mediated immunosuppression: inhibition of dendritic cell maturation, reduction of T-cell tumor infiltration, and promotion of inhibitory cells in the tumor microenvironment; supporting data are also described. In addition, we discuss immunomodulatory properties observed within tumors following bevacizumab treatment. Combining anti–PD-L1 and anti-VEGF therapies has shown synergy and positive outcomes in phases I to III studies, particularly in settings where high VEGF levels are known to play an important role in tumor growth. We also review data from key studies supporting combination of bevacizumab and CIT, with a focus on PD-L1/programmed death 1 inhibitors.

From Genentech, Inc., South San Francisco, CA.

Conflicts of Interest and Source of Funding: D.S.C. and H.H. are employees of and hold stock or other ownership in Roche/Genentech. Support for third-party writing assistance for this manuscript—by Kia C. E. Walcott, PhD, of Health Interactions, Inc—was provided by F. Hoffmann-La Roche, Ltd.

Reprints: Daniel S. Chen, MD, PhD, 1 DNA Way, South San Francisco, CA 94080. E-mail: dschen@igmbio.com.

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