OnCo
pairingsPairing

PD-1 blockade + VEGF inhibition

Normalising the tumour's blood vessels lets immune cells in, and VEGF blockade removes an immunosuppressive signal.

Standard in RCC (pembrolizumab-axitinib, nivolumab-cabozantinib), HCC (atezolizumab-bevacizumab), endometrial (lenvatinib-pembrolizumab). Ivonescimab fuses both into one molecule and beat pembrolizumab in NSCLC.

Immune checkpoint inhibitors+Anti-angiogenic therapycombination
Rationale
VEGF suppresses dendritic cell maturation, promotes Tregs and MDSCs, and produces leaky vessels that block T-cell infiltration.
Evidence
Multiple phase 3 OS benefits; bispecific validation.

Connected

13top

cancers

4
Endometrial cancerHepatocellular carcinomaNon-small-cell lung cancerRenal cell carcinoma

technologies

2
Anti-angiogenic therapyImmune checkpoint inhibitors

drugs

3
ApprovedMonoclonal antibody (anti-PD-L1)
Atezolizumab · Tecentriq / Tecentriq Hybreza (SC)
Under reviewBispecific antibody (PD-1×VEGF)
Ivonescimab
ApprovedMonoclonal antibody (anti-PD-1)
Pembrolizumab · Keytruda / Keytruda Qlex (SC)

pathways

2
PD-1 / PD-L1 immune checkpoint & T-cell activationVEGF angiogenesis

pairings

1
Lenvatinib + pembrolizumab (pMMR endometrial cancer after platinum)

ideas

1
Use imaging to find the window when tumour blood vessels are working properly