172P Anlotinib as treatment for advanced non-small cell lung cancer: A systematic review and meta-analysis on overall survival and progression free survival

Abstract

Background: Non-small cell lung cancer (NSCLC) is the most frequent type of lung cancer that is associated with highest morbidity and mortality rate. Anlotinib is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase that is used as third-line treatment for NSCLC. The objective of this study was to evaluate the overall survival in patients with advanced NSCLC treated with anlotinib. Methods: Data was collected until January 5 th 2021 from PMC, PubMed, Google Scholar, Science Direct, and Scopus, using combination of keywords associated with advanced NSCLC and treatment using anlotinib in relation to their overall survival. Publications included are limited to English manuscripts that were published in the past 10 years. The studies include patients with advanced NSCLC and exclude patients with brain metastases that were controlled or uncontrolled for less than two months. All studies were reviewed and evaluated by authors. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS), with four studies were in moderate quality and one study was in good quality. Studies were also assessed using GRADE and showed moderate quality of evidence as there are neither inconsistency nor publication bias. Results: A total of five studies consisting of four clinical trial studies and one cohort study with a total of 1,353 advanced NSCLC patients were included. Studies claimed that anlotinib showed better PFS (HR = 0.48; 95% CI: 0,23-1.00; P = 0.05) and significantly improved OS (HR = 0.75; 95% CI: 0.67-0.83; P < 0.00001) compared to the placebo group. One study also presented better PFS and OS in refractory advanced NSCLC patients treated with anlotinib compared to the placebo group. Conclusions: Anlotinib is proven to be beneficial compared to placebo in treating advanced NSCLC patients as it shows significant improvement in overall survival and also better progression free survival. Studies also found that anlotinib possess remarkable efficacy and manageable safety profile, therefore should always be considered as candidate for treatment in advanced NSCLC.