First-line apatinib plus chemotherapy in extensive-stage small-cell lung cancer.

Abstract

e21104 Background: Angiogenesis plays a critical role in the growth, progression, and metastasis of numerous solid tumor types. Apatinib is a tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2 (VEGFR2), which is inhibits tumor angiogenesis. Etoposide plus cisplatin is a standard chemotherapy regimen for Extensive-Stage Small-Cell Lung Cancer (SCLC). Combining apatinib with chemotherapy may have a synergistic effect and improve efficacy. Methods: Eligible patients were adults with histologically or cytologically confirmed extensive-stage small-cell lung cancer, excluded patients with symptomatic brain metastases. Measurable extensive-stage small-cell lung cancer according to Response Evaluation Criteria in Solid Tumors (RECIST), version 1.1. Eligible patients were received six 21-day cycles of apatinib (250mg, orally daily) and chemotherapy (etoposide:100 mg/m2, ivgtt d1-3 of each cycle; cisplatin: 80 mg/m2, ivgtt d1 of each cycle), followed by local radiotherapy, apatinib (250mg, orally daily) maintenance therapy. For patients who have received treatment less than 6 cycles have disease progression, change the chemotherapy regimen combined with local radiotherapy. Primary endpoint: 6-month ORR. Secondary endpoints: 6-month DCR, PFS, safety. Results: We enrolled 40 patients between November 15, 2017 and April 18, 2019. Median age was 56 (range 28-67), 92.5% had an ECOG PS of 0. At the data cutoff (December 31, 2019), 27 patients were evaluated. In 27 patients who received apatinib for 4-26 months, with average of 10.6 months. The 6-month ORR was 63%, DCR was 85% [17 PR, 6 SD]. 9 patients (33.3%) achieved PFS, of which 8 patients progressed within 9 months and 1 patient progressed within 22 months. Patients who progressed within 6 months, the average duration of apatinib was 5.1 months. During the therapy, adverse events (AEs) were mostly Common grade 1-2 related AE, hypertension (37%), hand-foot syndrome (3.7%), and Hepatic Insufficiency (7.4%). Conclusions: Our study suggests that oral apatinib plus chemotherapy should be considered an active and safe treatment in patients with first-line treatment of extensive-stage small-cell lung cancer.