Heng Cao,Kai Liang,Peng Liu,Yonggui Hong,Jing Wang,Yuanyuan Ji,Lujuan Xu,Weilong Wu,Shengnan Guo,Xuekun Song. Efficacy and safety of anlotinib plus S-1 as thirdly-line or later-line treatment in advanced non-small cell lung cancer. Oncol Transl Med, 2020, 6: 10-15.
Efficacy and safety of anlotinib plus S-1 as thirdly-line or later-line treatment in advanced non-small cell lung cancer
Received:July 23, 2019  Revised:March 11, 2020
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KeyWord:non-small cell lung cancer (NSCLC); anlotinib; tegafur gimerac; advanced stage
Author NameAffiliationE-mail
Heng Cao Department of Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of caoheng123jun@126.com 
Kai Liang Department of Surgical Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University  
Peng Liu Department of Surgical Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University  
Yonggui Hong Department of Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of hygsir168@126.com 
Jing Wang Department of Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of  
Yuanyuan Ji Department of Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of  
Lujuan Xu Department of Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of  
Weilong Wu Department of Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of  
Shengnan Guo Department of Oncology, Anyang Tumor Hospital, The Fourth Affiliated Hospital of Henan University of  
Xuekun Song Henan University of Chinese Medicine, Zhengzhou 450000, China  
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Abstract:
      Objective Anlotinib, an oral vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor, has confirmed antitumor activity in lung cancer in both in vitro and in vivo assays, and has been recommended as third-line treatment agent in non-oncogene driven non-small cell lung cancer (NSCLC). This prospective study aimed to investigate the efficacy and safety of anlotinib plus S-1 for third- or later-line treatment in patients with advanced NSCLC. Methods Patients with histologically or cytologically confirmed NSCLC, and documented disease progression following second-line chemotherapy, and/or epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment were enrolled in this study. The patients were treated anlotinib (8 mg daily d 1–14) and S-1 (60 mg/m2 d 1–14) and the treatment was repeated every 3 weeks. Treatment was continued until disease progression or unacceptable toxicity occurred. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and adverse events (AEs) were reviewed and evaluated. Results Forty-one patients were enrolled in the study between June 2018 and December 2018. The total ORR and DCR were 26.8% and 80.5%, respectively. The median PFS was 5.2 months [95% confidence interval (CI), 3.9 to 6.6 months]. In the univariate analysis, there was a significant difference in the median PFS between patients with brain metastases and those without brain metastases (4.8 months vs 5.9 months, respectively; P = 0.039). The Eastern Cooperative Oncology Group (ECOG) performance status (P = 0.002), lines of therapy (P = 0.015), and therapeutic evaluation (P = 0.014) were independent factors that influenced PFS. The most common AEs were hypertension, proteinuria, myelosuppression, gastrointestinal reactions, fatigue, and mucositis. Conclusion Anlotinib plus S-1 is an effective and safe regimen for advanced NSCLC as third- or later-line therapy.
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