阿帕替尼作为晚期非小细胞肺癌患者三线或后续治疗的疗效与安全性：一项回顾性研究
Efficacy and safety of apatinib as third- or further-line therapy for patients with advanced NSCLC: a retrospective study.
作者信息
Liang Jianmiao, Gu Weiguang, Jin Jun, Zhang Hua, Chen Zecheng, Tang Yicong, Zhang Shunda, Yang Shuang, Deng Yanming, Feng Weineng
机构信息
Department of Head and Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, Guangdong, China.
Oncology Department, Nanhai People's Hospital/The Second School of Clinical Medical, Southern Medical University, Foshan, Guangdong, China.
出版信息
Ther Adv Med Oncol. 2020 Oct 31;12:1758835920968472. doi: 10.1177/1758835920968472. eCollection 2020.
BACKGROUND
Apatinib, an oral small-molecule angiogenesis inhibitor, selectively inhibits vascular endothelial growth factor receptor VEGFR-2), which inhibits vascular endothelial growth factor (VEGF) stimulated endothelial cell migration and proliferation and decreases tumour growth and metastasis. Recently, the efficacy of multi-target angiogenic drugs has been demonstrated for many cancers, including non-small-cell lung cancer (NSCLC). The aim of this retrospective study was to evaluate the clinical efficacy of apatinib in patients with advanced NSCLC.
PATIENTS AND METHODS
We conducted a retrospective analysis of 70 patients with advanced NSCLC who received second-line and later treatment from November 2015 to July 2017 with poor results. Out of the 70 patients, 36 patients received apatinib treatment after second-line or later treatment, whereas 34 patients in the control group did not receive further treatment. The patients were treated with oral apatinib 500 mg once a day every day for 4 weeks per cycle. Treatment was continued in responding and stable patients until disease progression or intolerable toxicity. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and side effects of the drug were recorded and reviewed.
RESULTS
ORR, DCR, PFS, and OS were evaluated in 36 patients receiving apatinib and 34 patients in the control group. The ORR and DCR in patients receiving apatinib therapy were 22.2% and 77.8%, respectively. The median PFS and OS in the treatment group were 5.6 and 9.6 months, respectively. The median OS in the apatinib group was significantly longer than that in the control group (9.6 3.8 months; < 0.0001). In contrast, there were no differences in adverse reactions between the patients in the treatment and control groups.
CONCLUSION
Apatinib showed favourable efficacy and safety and can thus be used as a treatment option for patients with advanced NSCLC.
背景
阿帕替尼是一种口服小分子血管生成抑制剂，可选择性抑制血管内皮生长因子受体（VEGFR-2），从而抑制血管内皮生长因子（VEGF）刺激的内皮细胞迁移和增殖，并减少肿瘤生长和转移。最近，多靶点血管生成药物对包括非小细胞肺癌（NSCLC）在内的多种癌症的疗效已得到证实。这项回顾性研究的目的是评估阿帕替尼对晚期NSCLC患者的临床疗效。
患者与方法
我们对2015年11月至2017年7月接受二线及后续治疗但疗效不佳的70例晚期NSCLC患者进行了回顾性分析。在这70例患者中，36例患者在二线或后续治疗后接受了阿帕替尼治疗，而对照组的34例患者未接受进一步治疗。患者口服阿帕替尼，每日一次，每次500 mg，每周期持续4周。对有反应和病情稳定的患者持续治疗，直至疾病进展或出现无法耐受的毒性。记录并评估客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）以及药物的副作用。
结果
对36例接受阿帕替尼治疗的患者和对照组的34例患者评估了ORR、DCR、PFS和OS。接受阿帕替尼治疗的患者的ORR和DCR分别为22.2%和77.8%。治疗组的中位PFS和OS分别为5.6个月和9.6个月。阿帕替尼组的中位OS明显长于对照组（9.6对3.8个月；P<0.0001）。相比之下，治疗组和对照组患者的不良反应无差异。
结论
阿帕替尼显示出良好的疗效和安全性，因此可作为晚期NSCLC患者的一种治疗选择。
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