Lili Wang1,2, Zhen He1,2, Sen Yang1,2, Hong Tang1,2, Yufeng Wu1,2, Shaomei Li1,2, Baohui Han3, Kai Li4, Li Zhang5, Jianhua Shi6, Zhehai Wang7, Ying Cheng8, Jianxing He9, Yuankai Shi10, Weiqiang Chen11, Yi Luo12, Lin Wu12, Xiuwen Wang13, Kejun Nan14, Faguang Jin15, Jian Dong16, Baolan Li17, Yan Sun10, Qiming Wang1,2. 1. Oncology Department, Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou 450008, China. 2. Oncology Department, Henan Cancer Hospital, Zhengzhou 450008, China. 3. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China. 4. Department of Thoracic Oncology, Tianjin Medical University Cancer Hospital, Tianjin 300060, China. 5. Department of Respiratory Diseases, Peking Union Medical College Hospital, Beijing 100032, China. 6. Department of Oncology, Linyi Cancer Hospital, Linyi 276001, China. 7. Department of Internal Medicine-Oncology, Shandong Cancer Hospital, Jinan 250117, China. 8. Department of Thoracic Oncology, Jilin Cancer Hospital, Changchun 130012, China. 9. Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China. 10. Cancer Hospital Chinese Academy of Medical Sciences, Beijing 100021, China. 11. Department of Pulmonary Medicine, Lanzhou Military General Hospital, Lanzhou 730050, China. 12. Department of Medical Oncology, Hunan Cancer Hospital, Changsha 410006, China. 13. Department of Chemotherapy, Qilu Hospital of Shandong University, Jinan 250012, China. 14. Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China. 15. Department of Respiratory Diseases, Tang Du Hospital, Xi'an 710038, China. 16. First Department of Medical Oncology, Yunnan Cancer Hospital, Kunming 650118, China. 17. Department of General Medicine, Capital Medical University, Beijing Chest Hospital, Beijing 101149, China.
Abstract
BACKGROUND: Lung cancer remains one of the deadliest cancers worldwide. The ALTER0303 trial revealed that anlotinib might be used as a third-line or further treatment in non-small cell lung cancer (NSCLC) patients. Meanwhile, the impact of previous therapy strategies on the efficiency of anlotinib still remains unknown. METHODS: The subgroup of patients in ALTER0303 were analyzed by using Kaplan-Meier estimates, Pearson χ2, or Fisher's exact test. RESULTS: There was no statistical significance on progression-free survival (PFS) and overall survival (OS) among patients in different previous antiangiogenic treatments groups. Patients in the chest radiotherapy (CRT) group had longer median PFS than the non-CRT group (5.93 vs. 4.63 m, P=0.027). Regardless of what kind of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) and chemotherapy regimens were used previously, all patients gained longer PFS in the anlotinib group, while only patients treated with vinorelbine/platinum in the EGFR wild type group, pemetrexed/platinum, vinorelbine/platinum, and gefitinib in the EGFR mutation group, and EGFR TKI used as the first line group could benefit from anlotinib on OS. When the OS was calculated from the time of diagnosis to the death, anlotinib could have increased median OS about 6 months (33.8 vs. 27.8 m, P<0.001) compared to the placebo with a hazard ratio (HR) (95% CI): 0.77 (0.60, 1.00). CONCLUSIONS: This study indicated that previous bevacizumab or endostatin treatments had no impact on the efficiency of anlotinib. Patients with CRT history benefited more from anlotinib on PFS. EGFR TKI and chemotherapy treatment history had more impact on OS than PFS in patients treated with anlotinib compared to placebo. 2019 Translational Lung Cancer Research. All rights reserved.
BACKGROUND: Lung cancer remains one of the deadliest cancers worldwide. The ALTER0303 trial revealed that anlotinib might be used as a third-line or further treatment in non-small cell lung cancer (NSCLC) patients. Meanwhile, the impact of previous therapy strategies on the efficiency of anlotinib still remains unknown. METHODS: The subgroup of patients in ALTER0303 were analyzed by using Kaplan-Meier estimates, Pearson χ2, or Fisher's exact test. RESULTS: There was no statistical significance on progression-free survival (PFS) and overall survival (OS) among patients in different previous antiangiogenic treatments groups. Patients in the chest radiotherapy (CRT) group had longer median PFS than the non-CRT group (5.93 vs. 4.63 m, P=0.027). Regardless of what kind of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) and chemotherapy regimens were used previously, all patients gained longer PFS in the anlotinib group, while only patients treated with vinorelbine/platinum in the EGFR wild type group, pemetrexed/platinum, vinorelbine/platinum, and gefitinib in the EGFR mutation group, and EGFR TKI used as the first line group could benefit from anlotinib on OS. When the OS was calculated from the time of diagnosis to the death, anlotinib could have increased median OS about 6 months (33.8 vs. 27.8 m, P<0.001) compared to the placebo with a hazard ratio (HR) (95% CI): 0.77 (0.60, 1.00). CONCLUSIONS: This study indicated that previous bevacizumab or endostatin treatments had no impact on the efficiency of anlotinib. Patients with CRT history benefited more from anlotinib on PFS. EGFR TKI and chemotherapy treatment history had more impact on OS than PFS in patients treated with anlotinib compared to placebo. 2019 Translational Lung Cancer Research. All rights reserved.
Entities:
Keywords:
Non-small cell lung cancer (NSCLC); anlotinib; antiangiogenic therapy
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