Apatinib added when NSCLC patients get slow progression with EGFR-TKI: A prospective, single-arm study
Minghui Liu1, Xin Li1, Hongbing Zhang1
1Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People's Republic of China.
Background:
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) acquired resistance was an inevitably events in NSCLC treatment.
Aims:
Intending to overcome the acquired resistance of EGFR-TKI.
Materials & Methods:
A clinical trial was, we enrolled 12 patients who were slowly progressing on first-generation EGFR-TKI, and added apatinib when the patients got slow progression.
Results:
Seven patients were included in the efficacy analysis. The median PFS2 of apatinib combined with EGFR-TKI was 8.2 months (95% CI, 7.3 m-NA), and the total PFS reached 20.9 months (95% CI, 17.3 m-NA) when plus PFS1. All the adverse events were manageable. The median PFS was significantly longer for circulating tumor DNA (ctDNA)-cleared patients (8.4 months; 95% CI, 8.2-NA) than for those ctDNA not cleared (7.1 months; 95% CI, 6.9-NA) (p = 0.0082).
Discussion:
The addition of apatinib did improve the duration of first-generation EGFR-TKI use, and the duration was better than the first-line use of third-generation EGFR-TKI.
Conclusion:
The addition of apatinib when the patients got slow progression after initial EGFR-TKI therapy may be a good treatment option and the side effects are controllable. It is possible to monitor treatment efficacy using ctDNA.
Insights
Adding apatinib to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) can overcome acquired resistance in NSCLC treatment. This combination therapy improves progression-free survival and is a viable option with manageable side effects.
Area of Science:
- Oncology
- Pharmacology
- Genetics
Background:
- Acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) is a significant challenge in non-small cell lung cancer (NSCLC) treatment.
- Developing strategies to overcome this resistance is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of adding apatinib to first-generation EGFR-TKI in NSCLC patients with acquired resistance.
- To explore the potential of circulating tumor DNA (ctDNA) as a biomarker for treatment response.
Main Methods:
- A clinical trial enrolled 12 patients with slow progression on first-generation EGFR-TKI, adding apatinib to their treatment regimen.
- Efficacy and adverse events were assessed in seven patients. Progression-free survival (PFS) was analyzed, including PFS2 and total PFS (PFS1 + PFS2).
- Correlation between ctDNA clearance and PFS was investigated.
Main Results:
- The median PFS2 of the combination therapy was 8.2 months, with a total median PFS of 20.9 months.
- Patients who achieved ctDNA clearance had a significantly longer median PFS (8.4 months) compared to those with uncleared ctDNA (7.1 months) (p=0.0082).
- All adverse events associated with apatinib were manageable.
Conclusions:
- Adding apatinib to first-generation EGFR-TKI therapy is a promising treatment option for NSCLC patients who develop acquired resistance.
- This combination improves the duration of EGFR-TKI treatment and shows potential for monitoring efficacy via ctDNA.
More Related Videos
Related Concept Videos
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...