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Efficacy, safety and predictive indicators of apatinib after multilines treatment in advanced nonsquamous nonsmall cell lung cancer: Apatinib treatment in nonsquamous NSCLC
Author(s) -
Wu Di,
Liang Li,
Nie Ligong,
Nie Jun,
Dai Ling,
Hu Weiheng,
Zhang Jie,
Chen Xiaoling,
Han Jindi,
Ma Xiangjuan,
Tian Guangming,
Han Sen,
Long Jieran,
Wang Yang,
Zhang Ziran,
Xin Tao,
Fang Jian
Publication year - 2018
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12870
Subject(s) - apatinib , medicine , oncology , lung cancer , adverse effect , proportional hazards model , tyrosine kinase inhibitor , progression free survival , response evaluation criteria in solid tumors , performance status , confidence interval , cancer , progressive disease , gastroenterology , chemotherapy
Aim Patients with advanced nonsquamous nonsmall cell lung cancer (NSCLC) who experienced progression with two or more lines chemotherapy have no treatment options that clearly confer a survival benefit. As a novel vascular endothelial growth factor receptor‐2 tyrosine kinase inhibitor, apatinib has a certain antitumor effect for various solid tumors. The present study evaluated the efficacy and safety of apatinib in advanced nonsquamous NSCLC as salvage treatment in Chinese real‐world practice. Methods Twenty‐eight patients were enrolled in this observational study from October 2015 to May 2017. Progression‐free survival (PFS) and overall survival (OS) were graphed by Kaplan–Meier curve and intergroup comparisons were carried out by log‐rank test. Objective response rate (ORR), disease control rate (DCR) and adverse effects (AEs) were also evaluated. Results Seven patients obtained partial response, and 18 obtained stable disease, representing an ORR of 26% and a DCR of 93%. Median PFS and OS were 3 (95% confidence interval [CI] 2.6–3.4) and 7.4 (95% CI 1.3–13.5) months, respectively. The efficacy analysis showed that Eastern Cooperative Oncology Group (ECOG) performance status 0–1 was correlated with prolonged OS and PFS ( P < 0.05), and hypertension during apatinib treatment was correlated with prolonged OS ( P < 0.05). Cox regression showed that ECOG performance status ( P < 0.01) (RR = 0.231) (95% CI 0.083‐0.642) and hypertension during apatinib treatment ( P = 0.05) were predictive indicators for apatinib treatment. Grade 3–4 AEs with incidences of 10% or greater were hypertension (21%), hand‐foot syndrome (14%) and proteinuria (11%) which could be relieved by dose reduction. Conclusion In conclusion, apatinib has a certain therapeutic effect in patients with advanced nonsquamous NSCLC. ECOG performance status and hypertension during apatinib might be predictive indicators for treatment efficacy.