Abstract
Chemotherapy is the main treatment for advanced lung squamous cell carcinoma(LSCC) patients due to lack of effective targeted agents. Previous studies proved that apatinib, which is an antiangiogenic and small-molecule targeted drug, showed clinical benefit in patients with advanced non-squamous non-small cell lung cancer. In this study, we assessed the efficacy and safety of low-dose (125mg or 250mg, QD, oral) apatinib in the treatment of advanced LSCC. A total of 8 advanced LSCC patients clinical data were reviewed retrospectively including 1 patient treated only by apatinib and 7 patients combined with other anti-tumor therapies (i.e., bronchial artery embolization (BAE), chemotherapy, radiotherapy or surgery) between May 2016 to July 2017. Efficacy was evaluated with the RECIST version 1.1 and adverse effects (AEs) were graded using the NCI CTC version 4.0. One SD and 7 PR were confirmed, resulting in an objective response rate of 87.5% (7/8) and a disease control rate of 100% (8/8), respectively. The median progression-free survival (PFS) was 197 days (95% CI, 122-272 days), and the median overall survival (OS) was 252 days (95% CI,161-342 days). Both PFS and OS were 93 days for the patient with monotherapy, while the median PFS and median OS were 212 days (95% CI, 132-292 days) and 274 days (95% CI,182-366 days), respectively for the 7 patients with combined treatment. Patients with grade 3 or 4 AEs included 2 hemoptysis, 1 leukopenia and 1 fatigue. Patients characteristics are shown in the table. Low-dose apatinib combined with BAE, chemotherapy, radiotherapy or surgery is effective and well tolerated in advanced LSCC patients. Risk of massive hemoptysis should be considered in LSCC patients treated with apatinib alone. BAE or radiotherapy may play a role in the prevention and treatment of severe hemoptysis associated with apatinib.Further prospective studies with larger numbers of patients are required.
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