Serum levels of vascular endothelial growth factor-A and -B in patients with advanced non-small cell lung cancer treated with pembrolizumab: prognostic and predictive value

<bold>Background:</bold> Previous data on the predictive value of soluble VEGF-A in patients with non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors (ICIs) are limited, while the clinical relevance of other members of the VEGF family, such as VEGF-B, in this setting remains essentially unexplored. We herein aimed to investigate the prognostic and predictive value of baseline and post-treatment levels of serum VEGF-A and -B in patients with advanced NSCLC treated with ICIs. <bold>Methods:</bold> 55 patients with advanced NSCLC eligible to receive immunotherapy were prospectively enrolled. Serum VEGF-A and –B levels were measured in peripheral blood samples using ELISA, both at baseline and at the time of treatment response evaluation, and were correlated with prognosis (PFS, OS), treatment response and the remaining clinicopathological features of patients. <bold>Results:</bold> Mean age of patients was 66.5 years (SD=8.0 years); 65,5% of patients received chemotherapy and pembrolizumab combination while the remaining patients received pembrolizumab monotherapy. VEGF-B levels were significantly decreased after treatment (p=0,028) while VEGF-A levels were also reduced without reaching statistical significance. Increased post-treatment levels of VEGF-B were significantly associated with reduced OS, both in univariate and multivariate survival analysis (HR=2.99; p=0.049 and HR=3.37; p=0.032, respectively). <bold>Conclusions:</bold> Increased post-treatment VEGF-B levels may independently predict a worse OS in advanced-stage NSCLC patients treated with pembrolizumab.