P48.11 Anlotinib Versus Chemotherapy as a Third-Line or Further Treatment for Advanced Small Cell Lung Cancer

Abstract

The optimal third-line or further treatment for advanced small cell lung cancer (SCLC) remains unclear. Anlotinib,which is a novel multitarget tyrosine kinase inhibitor, could inhibit tumor angiogenesis and proliferative signaling. Therefore,this retrospective study aimed to compare the efficacy and safety of anlotinib versus chemotherapy of patients with advanced SCLC progressing after second-line or further treatment. This study included 55 advanced SCLC patients (n=28 for anlotinib group and n=27 for chemotherapy group) from Shanghai Chest hospital between January 2017 and September 2019.Detailed demographic, survival data,and safety data were collected. Kaplan-Meier method and log-rank test were used to assess median progression-free survival (PFS) and overall survival (OS) with 95% confidence intervals (CIs). PFS was significantly longer in the anlotinib group [median PFS 3.58 versus 2.56 months; hazard ratio (HR)=0.42,95% CI:0.24-0.75, P=0.003] than that in the chemotherapy group. Although anlotinib did not improve OS (median OS 5.32 versus 6.57 months; HR=1.21,95% CI:0.60-2.46,P=0.592),non-smokers derived more survival benefit from anlotinib than ever/current smokers (Pinteraction for OS=0.04).In addition, similar result was found for PFS (Pinteraction for PFS=0.08).Considerable improvement in disease control rate was observed in the anlotinib group over the chemotherapy group. Four (14.3%) patients in the anlotinib group versus five (18.5%) patients in the chemotherapy group had treatment-related grade 3-4 adverse events. Anlotinib treatment resulted in an improvement of PFS versus chemotherapy in previously treated SCLC,with a favourable safety profile. Non-smoking seemed to be a predictive factor of anlotinib efficacy. Prospective studies were needed to confirm our findings.