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小分子多靶点抗血管生成抑制剂治疗晚期胸腺癌:一项回顾性研究。

Small molecule multitarget antiangiogenic inhibitor treatments for advanced thymic epithelial tumors: A retrospective study.

机构信息

Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou, China.

Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.

出版信息

Thorac Cancer. 2024 Jan;15(2):122-130. doi: 10.1111/1759-7714.15167. Epub 2023 Nov 27.

Abstract

BACKGROUND

Thymic epithelial tumors (TETs) are rare malignant tumors with limited treatment options. No established second-line treatment regimen is available following the preferred first-line chemotherapy, resulting in unsatisfactory efficacy and poor prognosis for patients with advanced TETs. This study aimed to evaluate the efficacy of small molecule multitarget antiangiogenic inhibitors as well as the prognostic factors for advanced TETs.

METHODS

A retrospective study was conducted using data from a real-world database. Clinical information and survival follow-up data were collected from 52 patients with advanced TETs who received small molecule multitarget antiangiogenic inhibitors at Zhejiang Cancer Hospital between August 10, 2016 and August 10, 2022. The short-term efficacy of the treatments, survival time of the patients, and relevant prognostic factors of advanced TETs were analyzed.

RESULTS

Out of the 52 patients included in this study, 16 had thymoma and 36 had thymic carcinoma. The 52 patients had an overall response rate of 21.1% and a disease control rate of 94.2%. In addition, the median progression-free survival (PFS) was 8.05 months, and the overall survival (OS) was 25.00 months. Apatinib was given to 33 patients, anlotinib to 15 patients, and sunitinib or lenvatinib to four patients. Only seven patients received antiangiogenic inhibitors as their first-line therapy, 27 patients as their second-line therapy, and 18 patients as third-line or subsequent therapy. Meanwhile, 42 patients received monotherapy with an antiangiogenesis inhibitor, while 10 patients received combination therapy. Univariate analysis indicated that the combined treatment was associated with a superior OS (p = 0.044); multivariate analysis indicated that the combined treatment was an independent prognostic factor for PFS (p = 0.014) and OS (p = 0.012).

CONCLUSION

The findings suggest that small molecule multitarget antiangiogenic inhibitors are efficacious as second or post-line treatments as a viable alternative treatment option for patients with advanced TETs.

摘要

背景

胸腺瘤(TET)是一种罕见的恶性肿瘤,治疗选择有限。在首选的一线化疗后,没有确立的二线治疗方案,导致晚期 TET 患者的疗效不理想,预后较差。本研究旨在评估小分子多靶点抗血管生成抑制剂的疗效以及晚期 TET 的预后因素。

方法

本研究采用回顾性研究,使用浙江肿瘤医院 2016 年 8 月 10 日至 2022 年 8 月 10 日接受小分子多靶点抗血管生成抑制剂治疗的 52 例晚期 TET 患者的真实世界数据库中的临床信息和生存随访数据。分析治疗的短期疗效、患者的生存时间和晚期 TET 的相关预后因素。

结果

本研究共纳入 52 例患者,其中 16 例为胸腺瘤,36 例为胸腺癌。52 例患者的总缓解率为 21.1%,疾病控制率为 94.2%。此外,中位无进展生存期(PFS)为 8.05 个月,总生存期(OS)为 25.00 个月。阿帕替尼用于 33 例患者,安罗替尼用于 15 例患者,舒尼替尼或仑伐替尼用于 4 例患者。仅 7 例患者将抗血管生成抑制剂作为一线治疗,27 例患者作为二线治疗,18 例患者作为三线或后续治疗。同时,42 例患者接受抗血管生成抑制剂单药治疗,10 例患者接受联合治疗。单因素分析表明,联合治疗与 OS 改善相关(p=0.044);多因素分析表明,联合治疗是 PFS(p=0.014)和 OS(p=0.012)的独立预后因素。

结论

这些发现表明,小分子多靶点抗血管生成抑制剂作为二线或后线治疗药物,对晚期 TET 患者是有效的,是一种可行的替代治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a30a/10788475/1231b69e6b8f/TCA-15-122-g005.jpg

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