At picomolar concentrations, the endothelial barrier function of the neovasculature is impaired, enhancing chemotherapy penetration in murine models.6 In a previous phase 2 trial,7 NGR-hTNF monotherapy showed an arguably modest disease control with 44% of patients achieving disease control, with evidence of partial response (albeit 2%), and a median of 2·8 months progression-free survival. On the basis of evidence from preclinical studies and trials in lung cancer, a spindle poison (eg, vinorelbine) might well be the appropriate combination partner. Jonathan Ashton/Science Photo Library I report personal fees, advisory board participation, and research support from Roche and Bristol-Myers Squibb; grants and personal fees from Boehringer Ingelheim; and research support from Eli Lilly, Clovis Oncology, and Pierre Fabre, outside of the submitted work.