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Published on: June 26, 2019
Apatinib plus icotinib in treating advanced non-small cell lung cancer after icotinib treatment failure: a
Jianping Xu1, Xiaoyan Liu1, Sheng Yang1
1Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, People's Republic of China.
Background:
Treatment failure frequently occurs in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) who respond to EGFR tyrosine kinase inhibitors initially. This retrospective study tried to investigate the efficacy and safety of apatinib plus icotinib in patients with advanced NSCLC after icotinib treatment failure.
Patients And Methods:
This study comprised 27 patients with advanced NSCLC who had progressed after icotinib monotherapy. Initially, patients received oral icotinib (125 mg, tid) alone. When the disease progressed, they received icotinib plus apatinib (500 mg, qd, orally). Treatment was continued until disease progression, unacceptable toxicity or consent withdrawal.
Results:
Followed up to December 2016, the median time of combined therapy was 7.47 months, and eight of 27 patients were dead. The median overall survival was not reached, and median progression-free survival (PFS) was 5.33 months (95% CI, 3.63-7.03 months). Moreover, the objective response rate (ORR) was 11.1%, and the disease control rate (DCR) was 81.5%. A total of 14 patients received combined therapy as the second-line treatment, and the ORR and DCR were 7.1% and 78.6%, respectively; 13 patients received drugs as the third- or later-line treatment, with an ORR and a DCR of 15.4% and 84.6%, respectively. In addition, 11 patients experienced icotinib monotherapy failure within 6 months with median PFS of 7.37 months, and 16 patients had progression after 6 months with median PFS of 2.60 months. The common drug-related toxic effects were hypertension (44.4%) and fatigue (37.0%).
Conclusion:
Apatinib plus icotinib is efficacious in treating patients with advanced NSCLC after icotinib treatment failure, with acceptable toxic effects.
Insights
Apatinib plus icotinib shows efficacy in advanced non-small cell lung cancer (NSCLC) after initial treatment failure. This combination therapy offers acceptable safety for patients with EGFR-mutant NSCLC.
Area of Science:
- Oncology
- Pharmacology
Background:
- Treatment failure is common in EGFR-mutant NSCLC patients receiving tyrosine kinase inhibitors.
- Investigating novel therapeutic strategies is crucial for improving outcomes in advanced NSCLC.
Purpose of the Study:
- To evaluate the efficacy and safety of apatinib combined with icotinib in advanced NSCLC patients who have progressed on icotinib monotherapy.
- To assess the impact of this combination therapy on progression-free survival (PFS) and objective response rate (ORR).
Main Methods:
- A retrospective study involving 27 advanced NSCLC patients who failed icotinib monotherapy.
- Patients received icotinib followed by icotinib plus apatinib until disease progression, toxicity, or withdrawal.
Main Results:
- The median PFS was 5.33 months, with an ORR of 11.1% and a DCR of 81.5%.
- Hypertension and fatigue were the most common toxicities (44.4% and 37.0%, respectively).
- Efficacy varied based on prior treatment line, with higher ORR in later lines.
Conclusions:
- Apatinib plus icotinib demonstrates efficacy in advanced NSCLC patients post-icotinib failure.
- The combination therapy is associated with manageable toxic effects, suggesting a viable treatment option.
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