Anti-VEGF Therapy

The AVAGAST trial demonstrated that adding bevacizumab to chemotherapy provides clinical benefit over chemotherapy alone in advanced gastric cancer. Bevacizumab was the first anti-angiogenic agent approved for clinical use and is now considered standard of care across multiple advanced solid tumour settings. Anti-VEGF therapy suppresses tumour angiogenesis both by directly inhibiting tumour vasculature and by remodelling the tumour immune microenvironment to improve immune cell infiltration. The immunomodulatory effect of anti-VEGF therapy on the tumour immune microenvironment is proposed to synergise with PD-1 blockade, providing the basis for combining the two approaches.