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Semaphorin 3A overcomes cancer hypoxia and metastatic dissemination induced by antiangiogenic treatment in mice.

In a phase III trial that compared two common first-line antiangiogenic drugs, pazopanib and sunitinib, the response rates were just 31% and 24%, respectively.

New immunotherapies have been reported to achieve lengthy responses: in a phase III trial of nivolumab in people who had previously been given antiangiogenic therapy, the response rate was a modest 25%, but many of the responses were long-lasting4.

The rationale in this case is that the slowdown in tumour growth from the antiangiogenic treatment might create more favourable conditions for immunotherapy.

“It isn’t clear whether this occurs substantially in human patients with cancer and whether this has anything to do with antiangiogenic therapies not working very well,” Dudley says.