PV QA 4 - Poster Viewing Q&A 4
Purpose/Objective(s): The efficacy of third-line or beyond chemotherapy in advanced non-small cell lung cancer (NSCLC) patients is low. Apatinib, as a novel small molecule antiangiogenic drug, has demonstrated satisfactory anticancer activity across a broad range of malignancies. The aim of this study is to evaluate the efficacy and safety of apatinib alone or combined with radiotherapy in patients with advanced NSCLC after second-line or beyond treatment failure.
Materials/Methods: This study comprised 81 patients with advanced NSCLC who had progressed after second-line or beyond treatment. Patients received apatinib alone or combined with radiotherapy between August 2015 and November 2017. Survival and toxicities outcome were evaluated by Kaplan-Meier method and according to NCI-CTC4.0.
Results: After dose adjustment, 59 patients (72.8%) received 500 mg daily of apatinib, 12 patients received 250mg, and 10 received 425mg daily. 44(54.3%) patients received apatinib alone and 37(45.7%) patients received apatinib combined with radiotherapy to primary tumor or metastatic sites. The median progression free survival (PFS) and overall survival (OS) was 5.9 (95% CI:4.6-7.2）and 10.8 (95% CI: 9.4-12.1) months. Compared with apatinib alone, the median PFS in patients with apatinib combined with radiotherapy were 4.2 and 7.4 months (P=0.01), respectively. The median OS in apatinib monotherapy and apatinib combined with radiotherapy were 8.9 and 11.3 months (P=0.47), respectively. The incidence of adverse events in grades 3-4 were 24.7%. The most common adverse events in this study were hypertension(40.7%), hand-foot syndrome(35.8%), fatigue (27.1%), proteinuria(25.9%), gastrointestinal toxicity (22.2%) , hemorrhage (12.3%) and mouth mucositis (11.1%).
Conclusion: Apatinib alone or combined with radiotherapy is efficacious in treating patients with advanced NSCLC after two or more lines of treatment failure, with acceptable toxic effects.
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