Apatinib for EGFR-TKIs resistant NSCLC patients: Initial clinical experience.

Abstract

e14059 Background: The 3rd generation TKI is still not available for Chinese NSCLC patients with EGFR-mutant who develop acquired resistance following treatment with 1st EGFR tyrosine kinase inhibitors (EGFR-TKIs). Apatinib, a novel small molecule TKI targeted VEGFR2, recommended as third-line treatment for metastatic gastric cancer patients, might be used as an alternative strategy for these patients. This study is an initial clinical experience about Apatinib for EGFR-mutant NSCLC patients with 1stTKI resistance. Methods: Eight patients pathological diagnosed as adenocarcinoma with EGFR mutant were enrolled between January, 2016 and January, 2017. All patients had undergone TKI treatment and disease progression. They had an ECOG performance status (PS) of 0–1. 250 mg-500mg/day of Apatinib was continuously administered for two months, during which we observed the curative effect and adverse events closely. Informed consent was obtained from each patient before enrollment. Results: Computed tomography (CT) scan evaluation revealed that partial response (PR) occurred in 25% (2/8) patients and other 75% (6/8) showed stable disease (SD). There was no progressive disease (PD) occurred. Hypertension is one of the most frequent adverse reactions, which appeared in 50% (4/8) patients who were getting to be normal under antihypertensive agent. Others like hand-foot syndrome, anergy and temple elevated urine protein also appeared and could be better controlled. Conclusions: Apatinib is a safe and effective oral targeted drug on EGFR-mutant NSCLC patients with TKI resistance. It could provide a new therapy strategy for them before taking osimertinib. To further investigate the role of Apatinib in drug resistant EGFR-mutant NSCLC, large sample and additional clinical trials are needed. Table1. Clinicopathologic Characteristics of Patients. [Table: see text]