Abstract

BackgroundThe available treatment for advanced hepatocellular carcinoma (aHCC) remained limited in 2016 when our study was initiated. The phase II, ALTER0802 study (NCT02809534) evaluated anti-tumor activity and safety of anlotinib, a small molecular tyrosine kinase inhibitor (TKI), in patients (pts) with aHCC. MethodsPts aged 18-75 yrs with histologically/cytologically confirmed unresectable or metastatic HCC or prior progression/intolerance on standard therapy were enrolled if they were Child-Pugh ≤8 and ECOG PS≤1. Pts were divided into two cohorts: 1. those who did not receive prior systemic chemo or targeted therapy; 2. those who have received prior TKI treatment. Pts received anlotinib 12mg, 2 weeks on/ 1 week off, until disease progression or unacceptable adverse events (AEs). The primary endpoint was progression-free survival rate at 12 weeks (PFR12w); ORR, DCR, TTP, OS, PFR24w, and safety were secondary endpoints. ResultsAt the date of the interim analysis (Mar 7, 2019), 43 pts were enrolled (26 and 17 pts for cohort 1 and 2, respectively). In cohort 1, PFR12w was 80.8% (95%CI, 67.0-97.4); median OS (mOS) was 10.8mo (months; 95%CI, 8.0-NE [not estimated]); median TTP (mTTP) was 5.5mo (95%CI, 4.7-NE); DCR was 84.6% (95%CI, 65.1-95.6). In cohort 2, PFR12w was 58.8% (95%CI, 39.5-87.6); mOS was not reached; mTTP was 4.01mo (95%CI, 1.94-11.4); DCR was 76.5% (95%CI, 50.1-93.2). Other outcomes for both cohorts were presented in the table. Overall, treatment related AEs (TRAEs) were limited to mild hypertention, hand-foot skin reaction and bone and muscular pain. No grade IV or above AEs occurred.Table751PTableCohort 1 (n=26)Cohort 2 (n=17)ORR (n)3.85% (1)5.9% (1)CR (%)00PR (%)1 (3.85)1 (5.9)SD (%)21 (80.8)12 (70.6)PD (%)4 (15.4)4 (23.5)PFR24w (95%CI)43.2% (26.5-70.6)22.1% (10.5-55.8) ConclusionsIn this interim analysis, anlotinib showed durable anti-tumor activity and manageable toxicity in pts with aHCC regardless of in the first or second line treatment. Clinical trial identificationNCT02809534. Legal entity responsible for the studyJiangsu Chia-tai Tianqing Pharmaceutical Co., Ltd. FundingJiangsu Chia-tai Tianqing Pharmaceutical Co., Ltd. DisclosureAll authors have declared no conflicts of interest.

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