Dou Xue-Jun, Ma Run-Yang, Ren De-Wang, Liu Qiang, Yan Peng
Department of Thoracic Surgery, Aerospace Center Hospital, Beijing, 100049, People's Republic of China.
Department of Thoracic Surgery, Peking University International Hospital, Beijing, 102206, People's Republic of China.
Lung Cancer (Auckl). 2024 Mar 25;15:29-40. doi: 10.2147/LCTT.S444884. eCollection 2024.
This study aimed to investigate the effectiveness and tolerability of anlotinib plus PD-1 blockades in patients with previously immunotherapy treated advanced non-small-cell lung cancer (NSCLC).
A total of 67 patients with previously immunotherapy treated advanced NSCLC who received anlotinib plus PD-1 blockades in clinical practice were screened retrospectively. All the PD-1 blockades used in this study were approved in China and consisted of sintilimab, camrelizumab, tislelizumab and pembrolizumab. Effectiveness and safety of anlotinib plus PD-1 blockades were assessed, and all patients were followed up regularly. Clinical significance between response status to previous immune-related treatment regimens and therapeutic outcomes of anlotinib plus PD-1 blockades was further explored.
The best overall response among the 67 patients suggested that a partial response was observed in 16 patients, stable disease was noted in 41 patients and progressive disease was found in 10 patients, which yielded an objective response rate of 23.9% (95% CI: 14.3-35.9%) and a disease control rate of 85.1% (95% CI: 74.3-92.6%). Prognostic outcomes indicated that the median progression-free survival (PFS) was 6.1 months (95% CI: 2.37-9.83) and the median overall survival (OS) was 16.5 months (95% CI: 10.73-22.27). Exploratory analysis highlighted that patients who were intolerant to previous immune-related regimens (17 patients) might have a superior prognosis (median OS: 22.3 months vs 12.5 months, =0.024). Additionally, adverse reactions with any grades during anlotinib plus PD-1 blockades administration were observed in 62 patients (92.5%), of which 31 patients (46.3%) had ≥grade 3 adverse reactions. Most common adverse reactions were fatigue, hypertension, diarrhea and hepatotoxicity.
Anlotinib plus PD-1 blockades demonstrated promising effectiveness and tolerable safety in patients with previously immunotherapy treated advanced NSCLC. Those who were intolerant to previous immune-related regimens might benefit significantly from treatment with anlotinib plus PD-1 blockades. This conclusion should be confirmed in future studies.
本研究旨在探讨安罗替尼联合PD-1抑制剂治疗既往接受过免疫治疗的晚期非小细胞肺癌（NSCLC）患者的有效性和耐受性。
回顾性筛选67例在临床实践中接受安罗替尼联合PD-1抑制剂治疗的既往接受过免疫治疗的晚期NSCLC患者。本研究中使用的所有PD-1抑制剂均在中国获批，包括信迪利单抗、卡瑞利珠单抗、替雷利珠单抗和帕博利珠单抗。评估安罗替尼联合PD-1抑制剂的有效性和安全性，并对所有患者进行定期随访。进一步探讨既往免疫相关治疗方案的反应状态与安罗替尼联合PD-1抑制剂治疗结果之间的临床意义。
67例患者的最佳总体反应显示，16例患者观察到部分缓解，41例患者疾病稳定，10例患者疾病进展，客观缓解率为23.9%（95%CI：14.3-35.9%），疾病控制率为85.1%（95%CI：74.3-92.6%）。预后结果表明，中位无进展生存期（PFS）为6.1个月（95%CI：2.37-9.83），中位总生存期（OS）为16.5个月（95%CI：10.73-22.27）。探索性分析强调，对既往免疫相关方案不耐受的患者（17例）可能预后较好（中位OS：22.3个月对12.5个月，=0.024）。此外，62例患者（92.5%）在安罗替尼联合PD-1抑制剂治疗期间出现任何级别的不良反应，其中31例患者（46.3%）出现≥3级不良反应。最常见的不良反应为疲劳、高血压、腹泻和肝毒性。
安罗替尼联合PD-1抑制剂在既往接受过免疫治疗的晚期NSCLC患者中显示出有前景的有效性和可耐受的安全性。对既往免疫相关方案不耐受的患者可能从安罗替尼联合PD-1抑制剂治疗中显著获益。这一结论应在未来研究中得到证实。
