Abstract
Angiogenic agents play an important role in the therapeutic strategy for advanced NSCLC. Apatinib is a novel tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor-2. The purpose of this study was to collect data on the clinical efficacy and side effects of oral apatinib as a second-or further-line in patients with advanced NSCLC in the first hospital of Jilin University. A total of 43 patients with advanced NSCLC who were hospitalized in the Cancer Center of the First Hospital of Jilin University from January 1, 2017 to December 31, 2018 were enrolled. This study included patients whose initial dose was apatinib 500mg per day. Statistical analysis was performed using the SPSS19.0 system. The Kaplan-Meier method was used for survival analysis and the COX proportional hazard model was used for single factor analysis. The difference was statistically significant at p<0.05. Among all patients, the objective response rate (ORR) is 11.6% and the disease control rate (DCR) is 72.1%. The median progression-free survival (PFS) was 3.7 months. The ORR and DCR of 30 patients with Eastern Cooperative Oncology Group (ECOG) score of 0-1 were 16.7% and 83.3%, respectively, and the median PFS was 5.4 months (95% CI 3.1-7.7 months). The ORR and DCR of 13 patients with ECOG score of 2 were 0 and 4.6%, respectively, and the median PFS was 2.7 months (95% CI 2.1-3.3 months). The difference between the two groups was statistically significant (P=0.012). The most common treatment-related AEs were hypertension (48.8%), hand-foot syndrome (39.5%), diarrhea was (18.6%), nausea and vomiting (18.6%), and the incidence of grade 3 to 4 adverse reactions was 9.3%. Apatinib is convenient, effective and safe in the treatment of advanced NSCLC patients, and the incidence of adverse reactions is low and controllable. ECOG score is the influencing factor of median PFS. For patients with ECOG score of 0-1, oral apatinib 250mg per day therapy can show a better therapeutic effect.
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