Low-dose apatinib monotherapy in advanced chemotherapy-refractory small cell lung cancer: a case series and literature review

Abstract

The therapeutic regimen for small cell lung cancer (SCLC) has changed little in the past several decades. Apatinib is a small molecule inhibitor of vascular endothelial growth factor receptor-2 tyrosine kinase. Apatinib has demonstrated efficacy against advanced gastric cancer and breast cancer, and recent studies have also reported its successful use in non-SCLC; however, its efficacy in SCLC remains unclear. In this study, we used apatinib as salvage therapy for chemotherapy-refractory SCLC. Five male patients with advanced SCLC were administered oral apatinib (250 mg/day) as 2nd- to 4th-line treatment. One patient showed a partial response to apatinib, one showed stable disease, and three patients showed progressive disease. The progression-free survival durations in the patients with stable disease and partial response were 1.5 and 3 months, respectively. Only three patients showed adverse effects, including mild hypertension, vomiting, and hand–foot syndrome, respectively, all of which were manageable. Apatinib might thus be a salvage option in patients with advanced SCLC after chemotherapy.

Observation on the Clinical Effect of Apatinib Combined with Chemotherapy in the Treatment of Advanced Non-Small Cell Lung Cancer

“… 20 Meanwhile, Liu’s report in the same period suggested that apatinib had partial reactions but only mild side effects, including mild hypertension, vomiting and hand-foot syndrome, which could be controlled. 21 According to our study, there was no significant difference in the incidence of adverse drug reactions between the two groups (p=0.23), which also confirmed that the combination of apatinib and chemotherapy did not increase adverse reactions.…”

[Retracted] Apatinib plus Radiotherapy on the Expression of CEA and VEGF in Advanced Oligometastatic Non‐Small‐Cell Lung Cancer

“…Studies have confirmed a close correlation between the VEGF and lymph node metastasis in NSCLC, and lymph node metastasis is the primary route of lung cancer metastasis. As such, it is speculated that VEGF receptor inhibitors play an important role in improving the prognosis of patients with oligometastatic lung cancer [ 10 ]. However, there is a paucity of studies reporting the application effect of apatinib in patients with oligometastatic lung cancer.…”

Successful treatment of radiotherapy and apatinib in patient with mediastinal mixed non-seminomatous germ cell tumor

“…The standard dose of apatinib in patients with gastric cancer is 850 mg, while the common application dose is 500 mg according to the use in of NSCLC and SCLC. [ 32 , 33 ] This suggests that the tolerance of different tumor species to apatinib is different, hence, the application dose should be individualized and an initial dose of 250 mg can also be selected clinically. In this report, low-dose apatinib monotherapy eventually eliminated residual tumors in a patient with primary MNSGCT.…”

“…The initial dose of apatinib was 500 mg per day, but it was reduced to 250 mg due to side effects of hoarseness, hypertension, HFSR, and proteinuria. The standard dose of apatinib in patients with gastric cancer is 850 mg, while the common application dose is 500 mg according to the use in of NSCLC and SCLC [32,33] . This suggests that the tolerance of different tumor species to apatinib is different, hence, the application dose should be individualized and an initial dose of 250 mg can also be selected clinically.…”