Apatinib as maintenance therapy in extensive-stage small-cell lung cancer: results from a single-center retrospective study

Abstract

PurposeTo evaluate the efficacy of maintenance apatinib after chemotherapy for extensive-stage (ED) small-cell lung cancer (SCLC).Patients and methodsThis was a retrospective analysis of 23 cases of extensive-stage SCLC admitted to the Affiliated Cancer Hospital of Zhengzhou University from January 2015 to December 2017. The patients without progression after induction chemotherapy received apatinib 250 mg per day until disease progression or unacceptable toxicity occurred. We analyzed the median progression-free survival (PFS), median overall survival (OS) and safety.ResultsOf 23 enrolled patients, 1 was lost to follow-up. The median PFS from the time of maintenance therapy was 4.1 months (95% CI 3.63–4.57 months). The median PFS from the time of induction chemotherapy was 8.3 months (95% CI 7.20–9.40 months). The median OS from the time of maintenance therapy was 12.5 months (95% CI 5.51–19.49 months). The median OS from the time of induction chemotherapy was 17.0 months (95% CI 9.86–24.14 months). The most frequent treatment-related adverse events were hand–foot syndrome (43.5%, 10/23) and secondary hypertension (30.4%, 7/23), followed by fatigue, proteinuria, nausea, and oral mucositis (17.4%, 13.0%, 13.0%, and 8.7%, respectively). Hematologic toxicity included thrombocytopenia (30.4%), leucopenia (26.1%), and anemia (17.4%). The main grade 3 or 4 toxicities were hand–foot syndrome (8.7%, 2/23) and hypertension (4.3%, 1/23).ConclusionMaintenance apatinib was safe and achieved encouraging PFS and OS in extensive-stage SCLC.

Safety of apatinib plus S‑1 for advanced solid tumor as palliative treatment

“…However, the mPFS and mOS of the patients of the present study was only 3.3 and 11.6 months, respectively, which was considered similar to another study (25). As an example, in a single-center retrospective study, 23 cases of extensive-stage SCLC had received apatinib as maintenance therapy and the mPFS and mOS was 4.1 and 12.5 months, respectively (25). A major reason may be that the patients with SCLC in the present study who received multi-course treatment had a poor KPS score.…”

Low-dose apatinib monotherapy in advanced chemotherapy-refractory small cell lung cancer: a case series and literature review

“…Two recent reports described the use of apatinib combined with pneumonectomy or/and radiotherapy in two patients with relapsed SCLC, 18 , 19 while other studies reported on the use of apatinib as maintenance therapy in patients with stable SCLC after induction chemotherapy. 20 , 21 Low-dose apatinib might thus be a possible therapeutic choice in patients with advanced SCLC. However, further large-scale randomized controlled trials are needed to confirm this.…”

“…In a recent case report, apatinib (425 mg/day) combined with pneumonectomy and/or radiotherapy was used in two patients with relapsed SCLC, 18 , 19 and two other studies also reported on the use of apatinib as maintenance therapy in patients with stable SCLC after induction chemotherapy. 20 , 21 Another report used higher-dose apatinib (500 mg/day) in patients with extensive SCLC. 22 However, there is currently no evidence for the use of low-dose apatinib as monotherapy in patients with advanced SCLC after failure of chemotherapy.…”

Apatinib in patients with extensive-stage small-cell lung cancer after second-line or third-line chemotherapy: a phase II, single-arm, multicentre, prospective study

“…These studies suggested that apatinib has promising activity and acceptable toxicity in ES-SCLC. 24 Therefore, we conducted this phase II, single-arm, multicentre study to prospectively investigate the efficacy and safety of apatinib in Chinese patients with ES-SCLC who had experienced disease progression after second-line or third-line chemotherapy.…”