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Published on: April 18, 2020
[Apatinib as Salvage Therapy for Heavily Pretreated SCLC]
1Department of State Guest, Institute of Health Management, the Chinese PLA General Hospital, Beijing 100853, China.
Abstract:
Small cell lung cancer (SCLC) was highly malignant and lack effective treatment after the failure of radiotherapy and chemotherapy. Antiangiogenic therapy had shown a certain effect in advanced SCLC. Apatinib, a new potent oral small-molecule tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor 2 (VEGFR-2), showed the effect of anti-angiogenesis. However, the efficacy in SCLC was rarely reported. We reported 1 case of advanced SCLC with Gilbert syndrome, the patient received Apatinib after the failure of 4 lines of chemotherapy, and achieved a partial response according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 standard after one month. The progression-free survival (PFS) was 5 months. Apatinib was well tolerated except recurrent grade 3 hyperbilirubinemia because of the metabolic disorder of Bilirubin. Salvage treatment with Apatinib for advanced SCLC deserved further exploration. .
Insights
Apatinib, an anti-angiogenic drug, showed partial response in advanced small cell lung cancer (SCLC) after chemotherapy failure. This targeted therapy offers potential for difficult-to-treat SCLC cases.
Area of Science:
- Oncology
- Pharmacology
Background:
- Small cell lung cancer (SCLC) is highly malignant with limited treatment options post-chemotherapy and radiotherapy failure.
- Antiangiogenic therapy, targeting tumor vascularization, presents a potential strategy for advanced SCLC.
Observation:
- A patient with advanced SCLC and Gilbert syndrome received apatinib after four prior chemotherapy lines.
- Apatinib, a VEGFR-2 inhibitor, was administered as a salvage treatment option.
Findings:
- The patient achieved a partial response (RECIST 1.1) after one month of apatinib treatment.
- Progression-free survival (PFS) was 5 months.
- Apatinib was generally well-tolerated, with the main adverse event being recurrent grade 3 hyperbilirubinemia due to Gilbert syndrome.
Implications:
- Apatinib demonstrates potential efficacy as a salvage therapy for advanced SCLC, even in patients with underlying bilirubin metabolism disorders.
- Further clinical investigation of apatinib for advanced SCLC is warranted to explore its therapeutic role.
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