A Retrospective Observational Study of Anlotinib in Patients with Platinum-Resistant or Platinum-Refractory Epithelial Ovarian Cancer

Abstract

Objective Anlotinib, an oral small-molecular tyrosine kinase inhibitor (TKI) on tumor angiogenesis and growth, has a wide spectrum of inhibitory effects on targets such as vascular endothelial growth factor receptors 2/3 (VEGFR2/3), etc. The efficacy and safety of anlotinib in the treatment of platinum-resistant or platinum-refractory ovarian cancer were evaluated. Patients and Methods Patients with platinum-resistant or platinum-refractory ovarian cancer that treated with anlotinib in the Affiliated Cancer Hospital of Zhengzhou University from May 2018 to March 2020 were included. Medical records were reviewed in terms of objective response, survival outcomes, and safety. Results A total of 38 patients were analyzed. The median progression-free survival and the median overall survival were 7.7 months (95% CI: 6.7–8.7) and 16.5 months (95% CI: 13.3–19.7), respectively. About 17 patients received anlotinib monotherapy, and the median progression-free survival was 7.7 months (95% CI: 6.3–9.1). A total of 19 cases received anlotinib plus chemotherapy with a median progression-free survival of 8.0 months (95% CI: 4.8–11.2). A total of 2 cases received anlotinib plus anti-PD-1 antibody pembrolizumab, and 1 case had partial response, the other progressive disease. The objective response rate was 42.1% while the disease control rate was 86.8%. A total of 5 patients experienced dose reduction from 12 mg to 10 mg because of adverse effects. The most common adverse effects were hypertension (31.6%), fatigue (28.9%), anorexia (26.3%) and hand-foot syndrome (23.7%). No treatment-related deaths were recorded. Conclusion Anlotinib produced moderate improvements in progression-free survival and overall survival in patients with platinum-resistant or platinum-refractory ovarian cancer. It indicates that anlotinib maybe a new treatment option for patients with platinum-resistant or platinum-refractory ovarian cancer.

Combination of Anti-PD-1 Antibody, Anlotinib and Pegaspargase “Sandwich” With Radiotherapy in Localized Natural Killer/T Cell Lymphoma

“…Collectively, strong reasons exist to support the multidimensional synergetic effects of anlotinib combined with anti-PD-1 antibodies. In a series of prospective and observational studies, the encouraging efficacy data of anti-PD-1 antibody plus anlotinib have been reported (22,(34)(35)(36). In this study, interim analysis after 2 cycles of treatment showed a CR rate (CRR) of 50% and an ORR of 100%, indicating that this regimen could induce a rapid remission in NKTL.…”

Efficacy and Safety of Anlotinib Combined with PD-1 Blockades for Patients with Previously Treated Epithelial Ovarian Cancer: A Retrospective Study

“…Interestingly, a previous retrospective study included a total of 38 patients with platinum-refractory EOC who received anlotinib-based regimen. 32 And the results indicated that ORR of anlotinib monotherapy was 23.5%. On the other hand, pembrolizumab and nivolumab as monotherapy had been investigated among patients with advanced ovarian cancer.…”

“…It should be noted that the median OS in our study was slightly longer than that in the Keynote-028 trial (median OS: 18.5 vs 13.8 months) and the median OS in the retrospective study regarding anlotinib in EOC (median OS: 18.5 vs 16.5 months). 32 , 33 We speculated the possible explanation could be the license of another immunotherapy and PARP inhibitors (Olaparib and Niraparib) since 2018. To our knowledge, PARP inhibitors also demonstrated potential clinical benefit for patients with treatment-refractory EOC as the subsequent line administration.…”

“…Additionally, the most common TRARs of the combination regimen were hypertension, hand and foot syndrome, proteinuria and bleeding, which could be attributed to the treatment of anlotinib and were consistent with the safety profile of the previous study regarding anlotinib in patients with EOC. 32 Another immune-related adverse reactions such as rash, reactive cutaneous capillary endothelial proliferation (RCCEP) and pneumonia were observed with relatively low incidence, which might be resulted from the treatment of PD-1 blockades. 40 Interestingly, RCCEP was deemed as the specific adverse reaction of camrelizumab that was administered among 18 patients in our study.…”

A Retrospective Cohort Study Evaluates Clinical Value of Anlotinib in Persistent, Metastatic, or Recurrent Cervical Cancer After Failure of First-Line Therapy

“…It has been approved by the China State Food and Drug Administration (CSFDA) for locally advanced or metastatic non-small cell lung cancer patients who have progressed or relapsed after receiving at least two types of systemic chemotherapy in the past. 8 Moreover, studies have reported that the drug has shown promising efficacy and safety in esophageal squamous cell carcinoma, 9 soft tissue sarcoma, 10 medullary thyroid carcinoma, 11 ovarian cancer, 12 and other tumors. 13 However, no clinical studies have reported the efficacy and safety of anlotinib in patients with cervical cancer, let alone assessing whether the efficacy of anlotinib is better than single anti-VEGF drugs.…”