Abstract 4008: Association of lung cavitation development with apatinib treatment outcomes in advanced gastric and NSCLC patients with multichemotherapy failure

Abstract

Abstract Purpose: Patients who receive antiangiogenic agents commonly develop cavitation in their lung lesions. This symptom has also been found in apatinib-treated patients with lung tumors. The present study evaluated the frequency and clinical outcomes of patients who developed tumor cavitation following apatinib treatment. Experimental Design: This was a retrospective study of 189 patients with lung tumors who were treated with 250 mg per day of apatinib between February 1, 2015, and May 19, 2017. Clinical data were retrieved from their medical records, and chest imaging findings were documented. Survival data were analyzed with Kaplan-Meier estimates and were compared with a log-rank test. OR values were analyzed for the effect factor of cavitation development. Results: Cavitation development showed a benefit for patients on apatinib therapy regardless of whether they had primary or metastatic lung cancer. For patients without cavitation, metastatic lung cancer had greater 6-month LRC, PFS and OS rates than did primary lung cancer. No significant association was found between histological type and survival analysis in apatinib-treated NSCLC patients. Increased CEA levels promoted PFS in patients on apatinib who developed cavitation. However, changes in CEA values did not predict LRC, OS or PFS in patients who developed no cavitation. OR analysis showed that increased CEA levels were a risk factor for cavitation development. Interpretation: This was a retrospective real-world study approved by the ethics committee of the Affiliated Hospital of Qingdao University. Patients with advanced or metastatic gastric cancer and NSCLC who had progressed or relapsed after undergoing at least two lines of systemic therapy in accordance with NCCN guidelines and had never received antiangiogenic therapy were included. Conclusions: Lung cavitation development is common with apatinib therapy and is a potential prognostic biomarker. CEA is not a prognostic biomarker but is a prospective biomarker for lung cavitation in apatinib-treated patients. Note: This abstract was not presented at the meeting. Citation Format: Man Jiang, Chuantao Zhang, Dong Liu, Na Zhou, Yongjie Wang, Helei Hou, Tianjun Li, Hongying Lv, Jingjuan Zhu, Chuanyu Zhang, Xiaochun Zhang. Association of lung cavitation development with apatinib treatment outcomes in advanced gastric and NSCLC patients with multichemotherapy failure [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4008.