The efficiency of apatinib plus S-1 as second-line or laterline chemotherapy for advanced non-small-cell lung cancer.

Abstract

e20549 Background: There is no standard treatment strategy for patients with advanced non-small cell lung cancer (NSCLC) who experienced progression with three or more lines of chemotherapy. Apatinib, a new tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2 (VEGFR-2), has been shown confirming antitumor activity and manageable toxicities in breast and gastric cancers. Clinical trials of apatinib on non-small cell lung cancer show that progression-free survival is improved, but the objective response rate is still low. However, It remains to be explored whether the combined treatment of apatinib plus S1 could be further effective on NSCLC. Methods: We retrospectively assessed the efficacy and safety of apatinib plus S1 in patients with advanced NSCLC after the failure of second or third-line chemotherapy. The study group comprised 12 patients who received oral apatinib, at a dose of 250 mg daily, and S1, at a dose of 40-60mg bid D1-14, repeat every 3 weeks, for progression after the failure of second or third-line chemotherapy for advanced NSCLC. Treatment was continued until disease progression. Results: Between Mar 30, 2016 and Feb 1, 2017, 12 patients were enrolled. In 12 patients, there were 10 patients available for efficacy and safety evaluation. 4/10 (40%) patients experienced dose reduction during treatment. Followed up to Feb 1, 2016, the median during time of treatment was 3 months. According to RECIST criteria, the disease control rate was 80%, 8/10 (partial response 50%, 5/10 and stable disease 30%, 3/10). The most frequent treatment-related adverse events were secondary hypertension (40%, 4/10), oral mucositis (40%, 4/10), hand-foot syndrome (30%, 3/10) and fatigue (30%, 3/10). Main grade 3 or 4 toxicities were hypertension (20%, 2/10), oral mucositis (10%, 1/10) and fatigue (10%, 1/10). Conclusions: Apatinib plus S1 exhibits superior activity and acceptable toxicity for the heavily pretreated patients with advanced non-small cell lung cancer.