P76.31 Clinical Study of Apatinib Combined with Radiation Therapy in Advanced Non-small Cell Lung Cancer Patients with Brain Metastasis

Abstract

Radiotherapy of whole brain has been the basis in the treatment of non-small cell lung cancer (NSCLC) patients (pts) with brain metastasis, which can improve the rate of survival and reduce the rate of local recurrence. However, radiation therapy of whole brain can only extend the median survival time of most pts by 3 to 6 months. Previous studies had shown that antiangiogenic drugs combined with radiation therapy might prevent the progression of disease. We conducted this trial to investigate the efficacy and safety of apatinib (a antiangiogenic drugs against VEGFR-2) combined with radiation therapy for advanced NSCLC pts with brain metastasis. This study enrolled 18 advanced NSCLC pts with brain metastasis from Dec. 2017 to Oct. 2019. 18 pts all received apatinib combined with radiation therapy. Efficacy was evaluated every 6 weeks based on RECIST 1.1. This study was registered on National Clinical Trail Registry, and the registration number was NCT03356600. 66.7% (12/18) pts were available evaluated. The objective response rate (ORR) was 16.7% (2/12) and the disease control rate (DCR) was 83.3% (10/12). The most common adverse events were hypertension (44.4%, 8/18), hand-foot syndrome (22.2%, 4/18), bleeding (22.2%, 4/18) and fatigue (16.7%, 3/18). Main grade 3 or 4 toxicities were hypertension (5.6%, 1/18), hand-foot syndrome (5.6%, 1/18) and loss of appetite (5.6%, 1/18). None new adverse event occured. The median progression free survival (mPFS) of advanced NSCLC pts with brain metastasis who accepted apatinib combined with radiation therapy was 4.4 months. The longest treatment period was 11.4 months. Apatinib combined with radiation therapy shown a good clinical efficacy and safety in advanced NSCLC pts with brain metastasis. Patient's quality of life and the compliance of therapy had been increased by oral drugs based on radiation therapy.