作者
Fangfang Gao,Yanqiu Zhao,X. Li,Yanping Li,Tianjiang Ma,Li Q,Xiance Tang,Xiao Han,Seong Yoon Yi
摘要
Small cell lung cancer (SCLC) makes up about 15% of all newly diagnosed cases of lung cancer, approximately 70% diagnosed with extensive-stage SCLC (ES-SCLC). For ES-SCLC, the safety and efficacy data of anti-angiogenesis combined with chemotherapy are still seriously lacking. The median PFS of first-line standard regimen (PD-L1 combined with chemotherapy) in the treatment of ES-SCLC is about 5 months, which is comparable to that of chemotherapy alone. Therefore, we conducted a real-world study to observe and evaluate the efficacy and safety of anlotinib combined with chemotherapy in the treatment of first-line ES-SCLC. Eligible ES-SCLC pts (histologically or cytologically proven inoperable ES-SCLC; not received systematic treatment before; age≥18years; ECOG PS 0-2) were received anlotinib + etoposide + platinum for 4∼6 cycles, then anlotinib maintenance until the disease progresses or intolerable adverse reactions occur. During the treatment, dose reduction of anlotinib was permitted, which could be reduced to 10mg or 8mg if it was intolerable. The primary endpoint was progression-free survival (PFS), and secondary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS) and safety. Between March 2022 and April 2023, 60 patients were enrolled in this study and 34 patients were included in the evaluation of the treatment, with an average age of 65.5 (53.0-79.0) years old, 28 males (82.3%) and 6 females (17.7%). The ORR was 70.6%, and the DCR was 100.0%. The median PFS was 6.2 months (95% CI: 5.19 to 6.37). The median OS has not yet reached. The common grade 1-2 treatment-related adverse events (TRAEs) were hypertriglyceridemia (11.8%), hypercholesterolemia (11.8%), lymphocyte count decreased (8.8%), GGT increased (5.9%), cough (5.9%), platelet decreased (2.9%), grade 3 and above TRAEs included lymphocyte count decreased (5.9%), leukocyte decreased (5.9%), GGT increased (2.9%), hypodynamia (2.9%), neutrophil declined (2.9%). No higher-grade adverse reactions. Anlotinib combined with chemotherapy in the treatment of ES-SCLC shows good efficacy and controllable safety; no unexpected toxicity has been observed.