Efficacy and Safety of Drug-Eluting Bead Bronchial Arterial Chemoembolization Plus Anlotinib in Patients With Advanced Non-small-Cell Lung Cancer

Abstract

Aim: The aim of this study is to determine the efficacy and safety of the combination therapy of drug-eluting bead bronchial arterial chemoembolization plus anlotinib oral administration in the treatment of non-small-cell lung cancer (NSCLC).Methods: Consecutive data from 51 patients with advanced NSCLC were retrospectively collected from February 2018 to August 2019. All patients underwent drug-eluting bead bronchial arterial chemoembolization (DEB-BACE) followed by anlotinib treatment. Overall survival (OS) and progression-free survival (PFS) were calculated and analyzed using the Kaplan–Meier method and log-rank test, and factors associated with OS and PFS were assessed by a Cox proportional hazards test. Treatment response at 30 days was assessed by enhanced computed tomography (CT), and then the objective response rate (ORR) and disease control rate (DCR) were calculated. Treatment-related adverse events (TRAEs) were also evaluated.Results: The median OS was 18.4 months (95% CI, 16.6–20.2 months), and the median PFS was 8.4 months (95% CI, 6.2–10.6 months). The ORR and DCR for the whole cohort were 21.6 and 100%, respectively, at 30 days after the first cycle of treatment. Most of the treatment-related adverse reactions were mild and moderate and included anorexia, hypertension, fatigue, and hand-foot syndrome. Only eight (15.7%) patients developed grade 3 TRAEs. No deaths or other serious adverse reactions occurred. Both TNM stage and brain metastasis were independent risk factors for OS and PFS.Conclusion: DEB-BACE concomitant with anlotinib has promising efficacy and tolerable toxicity in patients with advanced NSCLC.

Advancements in Interventional Oncology of the Chest: Transarterial Chemoembolization and Related Therapies

“…Liu et al reviewed 51 patients with advanced (III-IV) NSCLC who underwent DEB-TACE plus BAI followed by treatment with anlotinib, an oral tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor, platelet-derived growth factor receptor, fibroblast growth factor receptor, and tyrosine kinase. 34 Chemotherapy regimen was selective arterial injection of pemetrexed/cisplatin for adenocarcinoma and gemcitabine/ cisplatin for squamous cell carcinoma followed by pirarubicin-loaded beads followed by Gelfoam particles. Three to six cycles of the procedure were performed for all patients as indicated by contrast-enhanced CT every 6 to 8 weeks.…”

Standard treatment-refractory/ineligible small cell lung cancer treated with drug-eluting beads bronchial arterial chemoembolization: a retrospective cohort study

“…This indicates that these regimens are promising approaches and can be tolerated by patients with STRI-SCLC. For patients with advanced NSCLC, Liu et al (18) reported a median PFS of 8.4 months and a median OS of 18.4 months for those treated with DEB-BACE plus anlotinib and indicated that DEB-BACE concomitant with anlotinib is effective and well-tolerated by these patients. An identical result was also observed in the present study, in which postoperative anlotinib was analyzed as the predictor of OS in patients with STRI-SCLC treated with DEB-BACE.…”

“…An identical result was also observed in the present study, in which postoperative anlotinib was analyzed as the predictor of OS in patients with STRI-SCLC treated with DEB-BACE. The potential mechanisms of the longer OS resulted from postoperative anlotinib were the following: (I) an embolization-induced hypoxic environment may increase the risk of recurrence and stimulate neovascularization of peritumoral tissue (18); and (II) anlotinib could inhibit the tumor angiogenesis and enhance the synergistic anticancer effects of DEB-BACE. This study has several limitations that should be noted.…”

“…Lin et al (17) analyzed 11 refractory patients with LS-SCLC treated with DEB-BACE but without sequential systemic therapy and reported promising results of 5.1 months for median progression-free survival (PFS) and 9.0 months for the median OS. Furthermore, 2 studies attempted DEB-BACE combined with molecular targeted therapy (such as anlotinib) or immunotherapy in patients with NSCLC and found that these regimens were promising approaches (18,19). However, to our knowledge, few studies have examined DEB-BACE for the treatment of STRI-SCLC.…”

Prognostic Evaluation of CT Imaging Big Data-Assisted Arterial Chemoembolization Combined with 125I Seed Implantation for Non-Small-Cell Lung Cancer

“…The first-line treatment for NSCLC is chemotherapy [ 6 ]. Arterial chemoembolization has been widely used in clinical practice because of its good efficacy in treating NSCLC and advantages of less trauma and less toxic side effects compared with intravenous systemic chemotherapy [ 7 ]. In recent years, minimally invasive interventional therapy for solid tumors is developing rapidly.…”