Ciblage de la voie de l'IGF (Insulin-like Growth Factor) en cancérologie pulmonaire

The pathway of Insulin-like Growth Factor (IGF-1) and its receptor (IGF-1R) is preponderant in solid tumours, and particularly in non small cell lung cancer (NSCLC). Several anticancer therapeutics, targeting this pathway, have been developed, whether it is monoclonal antibodies or small molecules (tyrosine kinase inhibitors, TKI). The results of phase II and III in stage IV NSCLC are promising, with response rate around 78% in non squamous cell carcinomas, that seem to be the histological type benefiting the most of anti-IGF-R therapies. Adverse effects are acceptable, essentially neutropenia or hyperglycaemia, with an interesting effect of metformin in this indication. Some other studies have underlined a synergic effect of EGFR (Epidermal Growth Factor Receptor) TKI and anti-IGF-1R antibodies. These promising results must be confirmed in phase III trials, currently opened or planned.