Effect of prior thoracic radiotherapy on prognosis in relapsed small cell lung cancer patients treated with anlotinib: a subgroup analysis of the ALTER 1202 trial

Abstract

Background: In ALTER 1202, anlotinib prolonged the progression-free survival (PFS) and overall survival (OS) of patients with relapsed small cell lung cancer (SCLC). The aim of this study was to explore the effect of front-line thoracic radiotherapy (RT) on the benefits of anlotinib as a third-line-or-beyond treatment.Methods: This was a subgroup analysis of a multicenter, randomized, double-blind, placebo-controlled phase 2 trial (ALTER 1202). The participants were divided into RT (previous thoracic RT) and non-RT subgroups. The outcomes included PFS, OS, objective response rate (ORR), disease control rate (DCR), and safety.Results: In the ALTER 1202 trial, 68 participants (anlotinib, n=46; placebo, n=22) received RT and 51 participants (anlotinib, n=35; placebo, n=16) did not. PFS was longer for anlotinib versus placebo in both the RT (5.49 vs. 0.69 months; P<0.001) and non-RT (2.83 vs. 0.76 months; P<0.001) subgroups. In the RT subgroup, the OS was longer for anlotinib vs. placebo (9.49 vs. 4.90 months; P=0.039). No differences were found in the ORR, but the DCR was higher in the anlotinib arm of the RT subgroup compared with the placebo arm (73.9% vs. 9.1%, P<0.001) and the non-RT subgroup (68.6% vs. 18.8%; P=0.002). Conclusions:In relapsed SCLC patients with previous thoracic RT, anlotinib might have DCR, PFS, and OS benefits compared with placebo. In those without previous thoracic RT patients, anlotinib might have DCR and PFS benefits compared with placebo. The safety was similar between anlotinib and placebo groups.

Efficacy evaluation of surgery combined with chemotherapy for stage IIIA small cell lung cancer patients: a retrospective analysis

“…Because of high recurrence and low OS rates for surgical treated LA-SCLC, surgery has been excluded from potential multimodality regimens since the 1990s (16)(17)(18). Current multimodality regimens based on surgery, chemotherapy, targeted therapy, immune checkpoint inhibitors (ICIs), and anti-angiogenic inhibitors (AAIs) have offered positive outcomes in the treatment of stage IIIA SCLC (IIIA-SCLC) disease, according to the TNM staging system for lung cancer (19)(20)(21)(22)(23)(24). However, the therapeutic regimen for IIIA-SCLC is still controversial.…”

Etoposide/platinum plus anlotinib for patients with transformed small-cell lung cancer from EGFR-mutant lung adenocarcinoma after EGFR-TKI resistance: a retrospective and observational study

“…In ALTER 1202 study, the novel antiangiogenic agent anlotinib as a third-or further-line treatment achieved better mPFS (4.1 vs. 0.7 months, P < 0.0001) and mOS (7.3 vs. 4.9 months, P = 0.0029) than the placebo group for patients with extensive-stage SCLC (ES-SCLC) (23). Consequently, the Chinese Society of Clinical Oncology (CSCO) recommended anlotinib as the only antiangiogenic agent for refractory ES-SCLC in China on August 30, 2019.…”

Etoposide/platinum plus anlotinib for patients with transformed small-cell lung cancer from EGFR-mutant lung adenocarcinoma after EGFR-TKI resistance: A retrospective and observational study

“…Currently, antiangiogenesis therapy targeting VEGF has become an indispensable strategy for cancer treatment. In ALTER 1202 study, the novel antiangiogenic agent anlotinib as a third-or further-line treatment achieved better mPFS (4.1 vs. 0.7 months, P < 0.0001) and mOS (7.3 vs. 4.9 months, P = 0.0029) than the placebo group for patients with extensive-stage SCLC (ES-SCLC) (Liu et al 2021).…”