Efficacy, safety, and prognostic factors of apatinib plus platinum doublet chemotherapy in advanced non-small cell lung cancer.

Abstract

Anti-angiogenesis drugs are applicable in treating advanced non-small cell lung cancer (NSCLC); however, the related data regarding apatinib, a Chinese domestic anti-vascular endothelial growth factor receptor-2 (VEGFR-2) production, are limited. Therefore, this study explored the efficacy and safety of apatinib plus platinum doublet chemotherapy in treating patients with advanced NSCLC. Twenty-four patients with advanced NSCLC were retrospectively enrolled. All patients received platinum doublet chemotherapy combined with apatinib 250 mg daily. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events were analyzed. Zero (0.0%), seven (29.2%), 11 (45.8%), and six (25.0%) patients had partial response (PR), stable disease (SD), and progressed disease (PD), respectively, resulting in an ORR of 29.2% and a DCR of 75.0%. The median PFS was 12.6 months (95% CI: 3.9-21.3 months) with a 1-year PFS of 56.1%, and the median OS was 18.3 months (95% CI: 13.0-23.5 months) with a 1-year OS of 73.9%. Age ≤60 years (P = 0.034), ECOG performance score 1 (vs. 2; P = 0.005), and first-line treatment (vs. second or higher line treatment; P = 0.043) correlated with longer PFS. The most common treatment-related adverse events included fatigue (83.3%), nausea (79.2%), myelosuppression (70.8), and vomiting (66.7%), while most of them were mild and manageable. Only four (16.6%) patients witnessed grade 3-4 myelosuppression. Apatinib plus platinum doublet chemotherapy is effective and well-tolerated in treating patients with advanced NSCLC; moreover, reduced ECOG PS and lower lines of treatment relate to its better efficacy.