Efficacy analysis of anlotinib combined with chemotherapy for advanced non-small cell lung cancer after failure of second-line chemotherapy

Abstract

Abstract:

Objective To observe the efficacy and safety of anlotinib combined with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) who failed second-line chemotherapy.MethodsA retrospective analysis was performed on 80 patients with advanced NSCLC who had failed second-line chemotherapy admitted in the Department of Oncology of Chaohu Hospital of Anhui Medical University from January 2017 to October 2019, and the patients were divided into control group (n=36) and observation group (n=44) according to the different treatment regimens. The control group was given pemetrexed + cisplatin, and the observation group adopted pemetrexed + cisplatin + anlotinib. The objective response rate (ORR), disease control rate (DCR), median progression-free survival (PFS), overall survival (OS), changes in levels of serum vascular endothelial growth factor (VEGF), carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) and treatment-related adverse reactions were compared between the two groups.ResultsAfter 2 cycles of treatment, the ORR in the control group and observation group were 5.56% (2/36) and 18.18% (8/44), with no statistically significant difference (χ²=1.85,P=0.174). The DCR in the two groups were 58.33% (21/36) and 81.82% (36/44), and the DCR in the observation group was significantly higher than that in the control group, with a statistically significant difference (χ²=5.33,P=0.021). The median PFS in the two groups were 4.0 months and 6.0 months, and the median PFS in the observation group was longer than that in the control group, with a statistically significant difference (χ²=28.47, P<0.001). The median OS in the two groups were 13.0 months and 14.8 months, with no statistically significant difference (χ²=1.56,P=0.212). The levels of serum VEGF [(21.72±5.42) ng/Lvs.(36.97±7.53) ng/L,t=14.13,P<0.001; (16.61±4.14) ng/Lvs. (38.85±8.61) ng/L,t=23.09,P<0.001], CEA [(4.91±1.58) ng/mlvs. (6.62±2.84) ng/ml,t=4.64,P<0.001; (3.07±1.32) ng/mlvs. (7.08±3.31) ng/ml,t=11.50,P<0.001] and CA199 [(16.83±5.23) U/mlvs. (20.95±7.94) U/ml,t=3.75,P<0.001; (13.37±5.85) U/mlvs. (21.66±8.72) U/ml,t=7.55,P<0.001] in the control group and observation group after 2 cycles of treatment were significantly decreased compared with those before treatment, and the levels of serum VEGF, CEA and CA199 in the observation group were significantly lower than those in the control group (t=4.78,P<0.001;t=5.68,P<0.001;t=2.76,P=0.007). The incidence of elevated blood pressure in the observation group was significantly higher than that in the control group [25.00% (11/44)vs.2.78% (1/36),χ²=7.67,P=0.006].ConclusionPemetrexed + cisplatin + anlotinib regimen for patients with advanced NSCLC who failed second-line chemotherapy can improve DCR, prolong PFS and improve the levels of serum tumor-related markers, with controllable adverse reactions.

Key words:Carcinoma,non-small-cell lung,Prognosis,Anlotinib,Efficacy evaluation

Sheng Xiao'an, Wang Chao, Xiao Xin, Tong Sihao. Efficacy analysis of anlotinib combined with chemotherapy for advanced non-small cell lung cancer after failure of second-line chemotherapy[J]. Journal of International Oncology, 2022, 49(3): 134-139.

Figures/Tables5

一般临床特征	对照组(n=36)	观察组(n=44)	t/χ²值	P值
年龄(岁)	56.15±8.38	54.84±9.86	0.63	0.529
体重指数(kg/m²)	22.11±2.72	21.69±2.94	0.66	0.513
性别
男	24	29	0.01	0.943
女	12	15
病理类型
腺癌	28	31	0.55	0.459
鳞状细胞癌	8	13
临床分期
ⅢB	6	5	0.13	0.720
Ⅳ	30	39
EGFR突变
是	9	12	0.05	0.818
否	27	32
PS评分(分)
0~1分	26	30	0.15	0.695
2分	10	14
吸烟史
有	25	28	0.30	0.585
无	11	16
一线化疗
长春瑞滨+顺铂	11	15
紫杉醇+顺铂	15	17	0.12	0.940
双氟胞苷+顺铂	10	12
二线化疗
紫杉醇+顺铂	7	11
吉西他滨+顺铂	14	16	0.35	0.839
多西他赛+顺铂	15	17

组别	CR	PR	SD	PD	客观缓解	疾病控制
对照组(n=36)	0(0)	2(5.56)	19(52.78)	15(41.67)	2(5.56)	21(58.33)
观察组(n=44)	0(0)	8(18.18)	28(63.64)	8(18.18)	8(18.18)	36(81.82)
Z/χ²值	2.57	1.85	5.33
P值	0.010	0.174	0.021

组别	VEGF (ng/L)								CEA (ng/ml)						CA199(U/ml)
组别	治疗前	治疗后		t值		P值			治疗前	治疗后	t值	P值			治疗前	治疗后			t值		P值
对照组(n=36)	36.97±7.53		21.72±5.42		14.13		<0.001	6.62±2.84		4.91±1.58	4.64		<0.001	20.95±7.94			16.83±5.23	3.75		<0.001
观察组(n=44)	38.85±8.61		16.61±4.14		23.09		<0.001	7.08±3.31		3.07±1.32	11.50		<0.001	21.66±8.72			13.37±5.85	7.55		<0.001
t值	1.03		4.78					0.66		5.68				0.38			2.76
P值	0.309		<0.001					0.512		<0.001				0.707			0.007

不良反应	对照组(n=36)			观察组(n=44)			χ²值	P值
不良反应	1~2级	3~4级	合计	1~2级	3~4级	合计	χ²值	P值
恶心呕吐	5	1	6	8	2	10	0.46	0.500
肝功能异常	4	0	4	6	0	6	0.12	0.734
肾功能异常	3	0	3	4	0	4	-	>0.999
血小板降低	2	0	2	1	0	1	-	0.585
骨髓抑制	1	0	1	2	0	2	-	>0.999
口腔黏膜炎	0	0	0	4	0	4	-	0.123
血压升高	1	0	1	10	1	11	7.67	0.006
咯血	0	0	0	2	0	2	-	0.499
乏力	2	0	2	7	0	7	2.13	0.146
手足综合征	1	0	1	4	0	4	-	0.372

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