First-line pemetrexed and carboplatin plus anlotinib for epidermal growth factor receptor wild-type and anaplastic lymphoma kinase-negative lung adenocarcinoma with brain metastasis

Zhang, Chu; Kong, Feng-Wei; Wu, Wenbin; Zhang, Miao; Yu, Guanzhen; Wang, Xiang; Liu, Yuan-Yuan

doi:10.1097/md.0000000000022128

Cited by 4 publications

(6 citation statements)

References 34 publications

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“… 33 A case reported that first-line pemetrexed and carboplatin plus anlotinib achieved CR for the treatment of EGFR wild-type NSCLC. 22 In our study, anlotinib plus chemotherapy had a tendency to prolong survival and had a significantly longer mPFS in patients <=65 years and first-line treatment than anlotinib monotherapy group. These studies suggest that anlotinib combined with chemotherapy may be an effective treatment for advanced NSCLC.…”

Section: Discussionsupporting

confidence: 43%

“…[11][12][13][14][15][16][17] Current studies have shown encouraging efficacy of the clinical use of anlotinib combination therapy, and a case reported first-line pemetrexed and carboplatin plus anlotinib achieved CR. [18][19][20][21][22] However, the sample size of current studies is small and more studies are still needed to confirm the efficacy and safety of anlotinib combination therapy in different patients with NSCLC.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Anlotinib-Containing Regimens in Advanced Non-Small Cell Lung Cancer: A Real-World Study

Sun,

Zhao,

Wang

et al. 2023

IJGM

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Purpose Anlotinib is widely used in the clinical treatment of non-small cell lung cancer (NSCLC), alone or in combination with other anticancer drugs. The aim of this study was to investigate the real-world efficacy and safety of anlotinib-containing regimens. Patients and Methods Confirmed advanced NSCLC patients who had received anlotinib alone or in combination were enrolled. An overall analysis of the efficacy and safety of anlotinib was performed in all patients, and then subgroup analysis was used to further compare the efficacy between anlotinib monotherapy and combination therapy. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were ADR, ORR, and DCR. Results A total of 240 patients were included. The overall median PFS was 8.5 months (95% confidence interval [CI]: 7.1–9.9 months). Anlotinib treatment regimens (monotherapy or combination therapy) and whether they received previous antiangiogenesis were associated with PFS. Anlotinib plus immunotherapy achieved longer PFS than anlotinib monotherapy (median PFS: 10.5 vs 6.5 months, p=0.007). Stratification analysis showed the PFS of anlotinib plus immunotherapy was significantly longer in male, adenocarcinoma, <=65 years old, patients stage IV, EGFR wild type, with extrathoracic metastasis, performance status scores ≥2, the first-line treatment, patients with a history of hypertension and no previous antiangiogenesis than anlotinib monotherapy. The median PFS of anlotinib plus chemotherapy, targeted therapy was slightly longer than anlotinib alone (respectively, 10.5 vs 6.5 months, p=0.095; 9.5 vs 6.5 months, p=0.177). Adverse reactions were mostly mild and acceptable, with hypertension being the most common. Conclusion Anlotinib is effective and tolerable in advanced NSCLC patients. Immunotherapy combination with anlotinib significantly improved PFS. The efficacy of anlotinib may be impaired by previous antiangiogenic therapy, which can be investigated in further studies.

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Section: Discussionsupporting

confidence: 43%

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Anlotinib-Containing Regimens in Advanced Non-Small Cell Lung Cancer: A Real-World Study

Sun,

Zhao,

Wang

et al. 2023

IJGM

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“…Presently, the combination therapy of chemotherapy and anlotinib is effective and widely used in clinical practice. Zhang C. et al (2020) reported the case of a patient with lung adenocarcinoma with brain metastasis treated with chemotherapy drugs plus anlotinib who achieved PFS of more than 2 years. Wang et al (2020).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Drug-Eluting Bead Bronchial Arterial Chemoembolization Plus Anlotinib in Patients With Advanced Non-small-Cell Lung Cancer

Liu

Zhang

Ren

et al. 2021

Front. Cell Dev. Biol.

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Aim: The aim of this study is to determine the efficacy and safety of the combination therapy of drug-eluting bead bronchial arterial chemoembolization plus anlotinib oral administration in the treatment of non-small-cell lung cancer (NSCLC).Methods: Consecutive data from 51 patients with advanced NSCLC were retrospectively collected from February 2018 to August 2019. All patients underwent drug-eluting bead bronchial arterial chemoembolization (DEB-BACE) followed by anlotinib treatment. Overall survival (OS) and progression-free survival (PFS) were calculated and analyzed using the Kaplan–Meier method and log-rank test, and factors associated with OS and PFS were assessed by a Cox proportional hazards test. Treatment response at 30 days was assessed by enhanced computed tomography (CT), and then the objective response rate (ORR) and disease control rate (DCR) were calculated. Treatment-related adverse events (TRAEs) were also evaluated.Results: The median OS was 18.4 months (95% CI, 16.6–20.2 months), and the median PFS was 8.4 months (95% CI, 6.2–10.6 months). The ORR and DCR for the whole cohort were 21.6 and 100%, respectively, at 30 days after the first cycle of treatment. Most of the treatment-related adverse reactions were mild and moderate and included anorexia, hypertension, fatigue, and hand-foot syndrome. Only eight (15.7%) patients developed grade 3 TRAEs. No deaths or other serious adverse reactions occurred. Both TNM stage and brain metastasis were independent risk factors for OS and PFS.Conclusion: DEB-BACE concomitant with anlotinib has promising efficacy and tolerable toxicity in patients with advanced NSCLC.

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“… 9 Several studies identified the feasibility of anlotinib plus chemotherapy in the treatment of advanced NSCLC. 10 , 11 The combination of antiangiogenic agent and chemotherapy may be a novel development direction for T790M‐negative EGFR ‐mutant advanced NSCLC.…”

Section: Introductionmentioning

confidence: 99%

“…Anlotinib reversed acquired resistance to EGFR TKIs via fibroblast growth factor receptor 1 (FGFR1) signaling pathway in T790M‐negative EGFR ‐mutant NSCLC in an in vitro trial 9 . Several studies identified the feasibility of anlotinib plus chemotherapy in the treatment of advanced NSCLC 10,11 . The combination of antiangiogenic agent and chemotherapy may be a novel development direction for T790M‐negative EGFR ‐mutant advanced NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Anlotinib plus chemotherapy for T790M‐negative EGFR‐mutant non‐sqNSCLC resistant to TKIs: A multicenter phase 1b/2 trial

Tian

Zheng

et al. 2022

Thoracic Cancer

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Background This multicenter phase 1b/2 trial aimed to explore the maximum tolerated dose (MTD), activity, and safety of anlotinib plus chemotherapy in patients with T790M‐negative epidermal growth factor receptor ( EGFR )‐mutant advanced nonsquamous non‐small cell lung cancer (NSCLC) after resistance to first‐ or second‐generation EGFR tyrosine kinase inhibitors (TKIs). Methods In the phase 1b stage, patients received anlotinib (8/10/12 mg, days 1–14) combined with cisplatin (75 mg/m 2 , day 1) or carboplatin (AUC = 5, day 1) plus pemetrexed (500 mg/m 2 , day 1) for a 3‐week cycle based on a 3 + 3 dose‐escalation design. In the phase 2 single‐arm stage, anlotinib was administered at MTD combined with platinum plus pemetrexed for four cycles, followed by anlotinib maintenance therapy. The primary endpoint of the phase 2 stage was progression‐free survival (PFS). Results The study was prematurely terminated due to slow accrual after 19 patients had been enrolled between January 18, 2019, and March 21, 2021. The MTD of anlotinib was 12 mg. The median PFS was 5.75 (95% confidence interval, 4.37–7.52) months. The objective response rate was 47.4% (95% confidence interval, 24.5%–71.1%). In the 12 mg group, seven (58.3%) patients experienced grade 3–4 treatment‐related adverse events, and the most common ones were hypertension (6 [50.0%]), decreased platelet count (2 [16.7%]), and hypertriglyceridemia (1 [8.3%]). No treatment‐related deaths occurred. Conclusion Anlotinib plus platinum and pemetrexed showed promising antitumor activity with manageable toxicity in patients with T790M‐negative EGFR ‐mutant advanced nonsquamous NSCLC after progression on first‐ or second‐generation EGFR TKIs.

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First-line pemetrexed and carboplatin plus anlotinib for epidermal growth factor receptor wild-type and anaplastic lymphoma kinase-negative lung adenocarcinoma with brain metastasis

Cited by 4 publications

References 34 publications

Efficacy and Safety of Anlotinib-Containing Regimens in Advanced Non-Small Cell Lung Cancer: A Real-World Study

Efficacy and Safety of Anlotinib-Containing Regimens in Advanced Non-Small Cell Lung Cancer: A Real-World Study

Efficacy and Safety of Drug-Eluting Bead Bronchial Arterial Chemoembolization Plus Anlotinib in Patients With Advanced Non-small-Cell Lung Cancer

Anlotinib plus chemotherapy for T790M‐negative EGFR‐mutant non‐sqNSCLC resistant to TKIs: A multicenter phase 1b/2 trial

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