Zhao Jun, Zhang Xiaoling, Gong Chaojie, Zhang Jialei
Department of Oncology, Changzhi People's Hospital, Changzhi, Shanxi Department of Geriatrics, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai Department of Anesthesiology, Changzhi People's Hospital, Changzhi, Shanxi, China.
Medicine (Baltimore). 2017 Dec;96(50):e9259. doi: 10.1097/MD.0000000000009259.
Small cell lung cancer (SCLC) is a lethal malignancy. Once relapsed, the disease is irreversible and most of the patients will die of cancer aggravation in 1 to 2 months. In the past several decades, little progress has been made in the systemic treatment of SCLC. Apatinib, as a novel small-molecule tyrosine kinase inhibitor specifically targeting the vascular endothelial growth factor receptor 2 (VEGFR2), has achieved progress in treatment of a variety of cancers. However, there has been no report of the targeted therapy with apatinib in SCLC yet.
A 63-year-old man, an ex-smoker, presented with a slight hoarseness and cough. The patient was admitted to our department with a primary diagnosis of SCLC at an extensive stage (ES-SCLC). After 17 months of successful first-, second-, and third-line chemotherapy, the disease eventually became relapsed. Then, apatinib treatment started promptly on demand by the patient and his family.
After presenting an informed consent, the patient received apatinib treatment immediately at a dose of 250 mg/day orally.
(1) On the 28th day of apatinib therapy, the symptoms of dyspnea and poor appetite of the patient were notably improved. (2) The CT scan taken on the 70th day showed that the pleural effusion in the left lung almost disappeared. (3) The elevated serum neuron-specific enolase (NSE) level was decreased. The patient died of acute respiratory failure on the 172nd day of apatinib treatment. Importantly, the tumor mass did not enlarge obviously during apatinib treatment.
Here, we presented a case with relapsed SCLC who unexpectedly responded to single-agent apatinib treatment. Therefore, this report will shed light on future studies of targeted therapy with apatinib in SCLC at different stages.
小细胞肺癌（SCLC）是一种致命的恶性肿瘤。一旦复发，病情不可逆转，大多数患者会在1至2个月内因癌症恶化而死亡。在过去几十年中，SCLC的全身治疗进展甚微。阿帕替尼作为一种新型的小分子酪氨酸激酶抑制剂，特异性靶向血管内皮生长因子受体2（VEGFR2），已在多种癌症的治疗中取得进展。然而，尚无阿帕替尼用于SCLC靶向治疗的报道。
一名63岁男性，既往吸烟，出现轻度声音嘶哑和咳嗽。该患者因广泛期小细胞肺癌（ES-SCLC）入院，初步诊断为SCLC。在成功进行了17个月的一线、二线和三线化疗后，疾病最终复发。随后，应患者及其家属的要求，立即开始阿帕替尼治疗。
在签署知情同意书后，患者立即接受阿帕替尼治疗，口服剂量为250毫克/天。
（I）阿帕替尼治疗第28天，患者呼吸困难和食欲不振症状明显改善。（2）第70天的CT扫描显示左肺胸腔积液几乎消失。（3）血清神经元特异性烯醇化酶（NSE）水平升高有所下降。患者在阿帕替尼治疗第172天死于急性呼吸衰竭。重要的是，在阿帕替尼治疗期间肿瘤肿块未明显增大。
在此，我们报告了一例复发SCLC患者，其对单药阿帕替尼治疗意外有效。因此，本报告将为未来不同阶段SCLC阿帕替尼靶向治疗的研究提供启示。
