The efficacy and safety of extended use of endostatin plus platinum-based doublet chemotherapy in patients with advanced non-small cell lung cancer: An analysis of a 10-year retrospective study.

Abstract

e20523 Background: Endostatin is a potent inhibitor of angiogenesis developed and approved in China. We aimed to evaluated the efficacy and safety of extended use of endostatin with platinum-based chemotherapy for advanced non-small cell lung cancer (NSCLC) in this study. Methods: We performed a retrospective analysis of chemotherapy-naïve patient with stage IIIB-IV or recurrent NSCLC who had been treated with first-line chemotherapy plus endostatin between January 2008 and June 2018. The primary endpoints were progression-free survival (PFS) and overall survival (OS). The Cox proportional hazards regression model was used to assess the prognostic importance of risk factors (age, gender, smoking status, ECOG performance status, stage, histology, EGFR gene status and endostatin cycles). Results: A total of 105 patients were eligible for analysis. The median (range) cycles of chemotherapy with endostatin were 4 (2-19). The objective response rate and disease control rate were 45.1% and 87.3%, respectively. Under multivariate analysis, non-smoking status and extended use of endostatin (≥4 cycles) were significantly correlated with better PFS, and squamous cell cancer and extended use of endostatin (≥4 cycles) were significantly correlated with better OS. The median (95% CI) PFS and OS for patients with extended use of endostatin (≥4 cycles) or not were 8.2 (5.6-12.7) vs. 5.3 (2.8-7.3) months, HR = 0.63, p= 0.014, and 21.2 (6.8-37.7) vs. 11.9 (4.1-23.9) months, HR = 0.77, p= 0.028, respectively. Patients with squamous cell cancers significantly benefited from the extended use of endostatin (≥4 cycles) (n = 55, p= 0.043) but not adenocarcinoma (n = 46, p= 0.089). Hematologic and gastrointestinal toxicities occurred more frequently in patients who received extended use of endostatin (≥4 cycles), but no statistically significant difference was detected in those who did not. Conclusions: In patients with advanced/recurrent NSCLC, extended use of endostatin (≥4 cycles) could provide additional survival benefits and satisfactory toxicity profiles, especially for those with squamous cell cancer, which merits further evaluation in a larger prospective study.