Efficacy and safety of anlotinib in the treatment of lung cancer.

Abstract

e21129 Background: Anlotinib was approved by the National Medical Products Administration (NMPA) on 5/8/18 and 8/30/19 for the third-line treatment of patients with advanced NSCLC and SCLC. But in the real world, Anlotinib is also used in the second-line treatment of lung cancer. This study aims to evaluate the efficacy of using Anlotinib in the second-line or further treatment of lung cancer in the real-world. Methods: We conducted a retrospective case-control study of NSCLC/SCLC patients at our center from 1/1/19 to 6/30/20. Patient demographic, clinicopathologic, therapeutic and outcomes data were collected. Kaplan-Meier curve and Cox proportional hazards were utilized. Results: Of 167 patients were enrolled in this study, 106 were in Anlotinib group and 61 were in chemotherapy group. The analysis found that pathological types, ECOG PS, and therapeutic were independent factors affecting PFS and OS in lung cancer patients (P < 0.05- can be a specific value). There was a significant difference in DCR between the anlotinib group and chemotherapy group(P < 0.05), and the anlotinib group was better than chemotherapy group in mPFS (4.1 vs 3.1 months, P = 0.001) and mOS (7.682 vs 6,386 months, P = 0.011). Among the second-line treatment patients, ORR, DCR and PFS were no difference between Anlotinib group and chemotherapy group (P > 0.05). The Anlotinib group was significantly better than Chemotherapy group in mOS (10.083vs6.737 months, P = 0.026). In third-line and further treatment patients, therapeutic and ECOG PS were independent factors of PFS and OS (P < 0.05), and pathological type was an independent factor of OS (P < 0.001). There was a significant difference in DCR between anlotinib group and chemotherapy group (P = 0.011). The mPFS (3.8vs2.5 months, P < 0.001) and mOS (7.407vs5.412 months, P = 0.023) are significantly better than chemotherapy group. In terms of adverse events, the incidence of hypertension (32.80%vs9.84%) and hand-foot syndrome (28.30%vs14.75%) in anlotinib group was higher than that in chemotherapy group, but the incidence of leukopenia (4.72%vs37.7) %), fatigue (14.15%vs34.42%), anorexia (16.04%vs39.34%) and other adverse events was lower than chemotherapy group, and the incidence of III-IV adverse events is low. Conclusions: Compared with using chemotherapy alone, the second-line and further treatment of Anlotinib can significantly elevate the survival of lung cancer patients, and the safety and tolerability are better.