Author(s) :

Eunchan Jung.

Volume/Issue :

Abstract :

Combination therapy with immune checkpoint inhibitors (ICIs) and anti-angiogenic agents has recently been an important therapeutic strategy in cancer treatment. This review discusses the mechanisms, clinical applications, limitations, and future research directions of this combination therapy. ICIs may restore exhausted T-cell activity and modify immune responses within the tumor microenvironment (TME), thereby contributing to tumor control in selected contexts. Anti-angiogenic agents target abnormal tumor angiogenesis, which can impair immune-cell infiltration and function and support tumor progression. By modulating vascular dysfunction and VEGF-mediated immunosuppression, anti-angiogenic therapy may enhance the activity of ICIs in certain tumor types, while ICI-induced immune activation may also influence vascular remodeling and antitumor immunity. Several ICI and anti-angiogenic agent combinations have been approved by the U.S. Food and Drug Administration (FDA) for selected malignancies and have demonstrated clinical benefit in specific patient populations. However, important questions remain regarding long-term efficacy, optimal dosing, treatment timing and sequencing, duration of therapy, immune-related adverse events, and tumor-specific resistance mechanisms. Responses may also differ across tumor types, drug classes, and tumor microenvironment states. Future research should focus on validating integrated biomarker strategies, improving toxicity prediction and management, clarifying resistance mechanisms, optimizing treatment sequencing, and extending follow-up to determine the durability of clinical benefit and safety. These efforts will be essential for improving the clinical use of combination therapy with ICIs and anti-angiogenic agents in appropriately selected patients.