Clinical investigation of the efficacy and toxicity of apatinib (YN968D1) in stage III/IV non‐small cell lung cancer after second‐line chemotherapy treatment: A retrospective study

Zhang, Di; Zhang, Chufeng; Huang, Jiaqi; Guan, Yan; Guo, Qisen

doi:10.1111/1759-7714.12898

Cited by 13 publications

(15 citation statements)

References 61 publications

(113 reference statements)

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“…12,13 Recent studies have also shown its efficacy in patients with NSCLC. [14][15][16][17] We previously reported that low-dose apatinib (250 mg/day) monotherapy resulted in similar PFS to higher-dose apatinib (500-750 mg/day) in patients with NSCLC, 16,17 and was associated with fewer adverse effects in these studies. 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.…”

Section: Introductionmentioning

confidence: 78%

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

et al. 2019

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The therapeutic regimen for small cell lung cancer (SCLC) has changed little in the past several decades. Apatinib is a small molecule inhibitor of vascular endothelial growth factor receptor-2 tyrosine kinase. Apatinib has demonstrated efficacy against advanced gastric cancer and breast cancer, and recent studies have also reported its successful use in non-SCLC; however, its efficacy in SCLC remains unclear. In this study, we used apatinib as salvage therapy for chemotherapy-refractory SCLC. Five male patients with advanced SCLC were administered oral apatinib (250 mg/day) as 2nd- to 4th-line treatment. One patient showed a partial response to apatinib, one showed stable disease, and three patients showed progressive disease. The progression-free survival durations in the patients with stable disease and partial response were 1.5 and 3 months, respectively. Only three patients showed adverse effects, including mild hypertension, vomiting, and hand–foot syndrome, respectively, all of which were manageable. Apatinib might thus be a salvage option in patients with advanced SCLC after chemotherapy.

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Section: Introductionmentioning

confidence: 78%

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

et al. 2019

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“…Our study demonstrated that low dose apatinib combined with pemetrexed could provide beneficial clinical outcomes and a favorable safety profile in advanced NSCLC patients. In this study, apatinib combined with pemetrexed produced a median PFS of 7.0 months, while the median PFS of apatinib monotherapy in patients with advanced nonsquamous NSCLC was 2.93 months in a phase II trial (14), indicating that apatinib combined with pemetrexed could provide effective clinical outcomes after failure of previous chemotherapy. Furthermore, apatinib monotherapy (250 to 750 mg qd) produced a median PFS and median OS of 3 (95% CI: 2.6-3.4) and 7.4 (95% CI: 1.3-13.5) months, respectively, in advanced non-squamous NSCLC after multi-line treatments (29).…”

Section: Discussionmentioning

confidence: 63%

“…Apatinib has been approved for the third-line or beyond treatment of advanced or metastatic gastric cancer recurrent from chemotherapy in China. At the same time, apatinib has shown potential anti-tumor activity in the treatment of several solid tumors, whatever in monotherapy or combination with other antitumor agents (10)(11)(12)(13)(14)(15). Furthermore, apatinib has been demonstrated to benefit patients of pretreated advanced NSCLC with a median PFS of 4.0 months in a retrospective study (12).…”

Section: Introductionmentioning

confidence: 99%

A single-arm, prospective study of apatinib mesylate plus pemetrexed in patients of advanced non-squamous non-small cell lung cancer after failure of previous chemotherapy

Dong¹,

Ou²,

Zhong³

et al. 2022

Ann Transl Med

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Background: The outcomes of advanced non-small cell lung cancer (NSCLC) patients after first-or second-line therapy are still discouraging due to a lack of effective treatment strategies. As a novel oral antiangiogenesis drug, apatinib, approved by the National Medical Products Administration of China only for advanced gastric cancer, has been increasingly used in off-label treatment across various cancer types in recent years, especially advanced NSCLC. It has shown strong anti-tumor efficacy and acceptable safety.Methods: This prospective study (NCT02974933) was conducted in patients with advanced NSCLC, who had suffered disease progression from the first-or second-line treatment, in Hubei Cancer Hospital.Eligible patients were enrolled and administrated with apatinib mesylate (500 mg qd) in combination with pemetrexed (500 mg/m 2 , every 4 weeks). The primary endpoint was progression-free survival (PFS). Results:From September 2016 to September 2019, a total of 21 advanced NSCLC patients were enrolled in Hubei Cancer Hospital. As of January 2021, treatment was discontinued in all patients, with 1 still in follow-up. There were 7/21 (33.3%) patients who achieved objective response. The median PFS and median overall survival (OS) were 7.0 months (95% CI: 6.15-7.85 months) and 13.0 months (95% CI: 7.39-18.6 months), respectively. Toxicities were tolerable or could be clinically managed. The most common grade 3-4 adverse events (AEs) were hypertension (14.3%, 3/21), hand-foot syndrome (4.7%, 1/21), and proteinuria (4.7%, 1/21). Hematological toxicities were moderate, with rare occurrences of grade 3/4 toxicities. During the period of treatment, there was no occurrence of treatment-related death.Conclusions: Apatinib plus pemetrexed demonstrated promising efficacy and a high level of safety profile in previously heavily-treated NSCLC patients. More definitive studies on the combination of apatinib and pemetrexed are warranted

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“… 24 These efficacy differences highlighted the gap between randomized controlled clinical trials and actual clinical practice. 25 Patients with an ECOG score of 2 were included in our study as well. To our knowledge, the influence of ECOG score on prognosis has been confirmed in many studies, which indicate that higher PS scores have worse prognoses.…”

Section: Discussionmentioning

confidence: 99%

Association Between PDL1 Genetic Variation and Efficacy of Apatinib Monotherapy in Patients with Previously Treated Advanced NSCLC: A Real-World Retrospective Study

Hu¹,

Li²,

Geng³

et al. 2021

IJGM

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Background This study aimed to explore associations between PDL1 polymorphisms and efficacy of apatinib for patients with previously treated advanced non–small cell lung cancer (NSCLC) in a real-world setting. Methods We retrospectively recruited 148 patients with previously treated advanced NSCLC from January 2015 to December 2019 continuously. Clinical efficacy in patients receiving apatinib treatment was evaluated. Adverse reactions were documented during treatment. Biological specimens of peripheral blood and cancer tissue biopsies were obtained for the genotyping of genetic variations in PDL1 and corresponding gene-mRNA expression, respectively. Univariate association analysis between the status of PDL1 genetic variations and survival was performed with Kaplan–Meier survival analysis. Results The objective response rate of the 148 patients was 17.6% and disease-control rate 68.9%. Prognostic data suggested that median progression-free survival (PFS) was 3.8 (95% CI 3.13–4.47) months and median overall survival (OS) 10.5 (95% CI 9.06–11.95) months. Regarding PDL1 genetic variation, only rs2297136 was of clinical significance. Prognosis analysis revealed that PFS and OS for the rs2297136 genotype were significantly different. Median PFS of patients with TC/CC and TT genotypes was 3 and 4.5 months, respectively ( P =0.006). Median OS of the two genotypes was 9 and 11.6 months, respectively ( P =0.04). Furthermore, the safety profile suggested that the most common adverse reactions were hypertension, dermal toxicity, fatigue, and oral toxicity. This study failed to find any significant association between adverse reactions and rs2297136. Interestingly, mRNA-expression analysis demonstrated that mRNA expression of PDL1 in biopsy cancer–tissue specimens was significantly different based on rs2297136-genotype status ( P <0.001). Conclusion The PDL1 polymorphism rs2297136 could be used as a potential biomarker for the prognosis of patients with NSCLC receiving apatinib monotherapy.

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Clinical investigation of the efficacy and toxicity of apatinib (YN968D1) in stage III/IV non‐small cell lung cancer after second‐line chemotherapy treatment: A retrospective study

Cited by 13 publications

References 61 publications

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

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

A single-arm, prospective study of apatinib mesylate plus pemetrexed in patients of advanced non-squamous non-small cell lung cancer after failure of previous chemotherapy

Association Between PDL1 Genetic Variation and Efficacy of Apatinib Monotherapy in Patients with Previously Treated Advanced NSCLC: A Real-World Retrospective Study

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