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The Efficacy and Safety of Apatinib and Anlotinib in Advanced Non-Small Cell Lung Cancer
Xiao Wei1, Yun Zhao1, Wenyue Yan2
1Department of Pharmacy, The First People's Hospital of Yancheng, Yancheng No.1 People's Hospital, Affiliated Hospital of Medical School, Nanjing University, Yancheng, Jiangsu, 224000, People's Republic of China.
Background:
Anlotinib and apatinib, both vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs), are clinically established in the treatment of advanced non-small cell lung cancer (NSCLC) in China, with anlotinib emerging as a standard treatment strategy. This study was conducted to evaluate the efficacy and safety of apatinib and anlotinib, and to compare their differences in treating patients with advanced NSCLC.
Patients And Methods:
We retrospectively analyzed the data of patients with advanced NSCLC treated with apatinib or anlotinib at a hospital in Eastern China from January 2017 to December 2021. The primary endpoint was progression-free survival (PFS), while secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety profile.
Results:
A total of 145 patients were included in this study. Median PFS (mPFS) was 3.53 months for the apatinib group and 5.3 months for the anlotinib group (HR = 0.59, 95% CI: 0.41-0.84; P = 0.004), and median OS (mOS) was 7.6 months versus 15.6 months (HR = 0.68, 95% CI: 0.46-1.00; P = 0.048), which all showed significant differences after adjusting for confounders (P < 0.05). Subgroup analysis revealed that the presence or absence of bone metastases significantly influenced PFS in both treatment groups. The ORR was 3.03% in the anlotinib group versus 10.13% in the apatinib group (P = 0.12), the DCR was 72.73% versus 51.90% (P = 0.21). No unanticipated adverse events (AEs) were observed. The incidence of grade 3-4 AEs was significantly higher in the apatinib group (31.65% vs 13.64%, P < 0.05).
Conclusion:
Anlotinib demonstrated greater efficacy and safety compared to apatinib in the treatment of advanced NSCLC, particularly in patients with bone metastases and EGFR(-).
Insights
Anlotinib shows improved efficacy and safety over apatinib for advanced non-small cell lung cancer (NSCLC). This VEGFR-TKI is particularly beneficial for patients with bone metastases, offering longer progression-free and overall survival.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Anlotinib and apatinib are established vascular endothelial growth factor receptor-tyrosine kinase inhibitors (VEGFR-TKIs) for advanced non-small cell lung cancer (NSCLC) in China.
- Anlotinib is increasingly recognized as a standard treatment for advanced NSCLC.
Purpose of the Study:
- To evaluate and compare the efficacy and safety of anlotinib versus apatinib in treating advanced NSCLC patients.
- To identify differences in treatment outcomes between these two VEGFR-TKIs.
Main Methods:
- Retrospective analysis of 145 advanced NSCLC patients treated between January 2017 and December 2021.
- Primary endpoint: progression-free survival (PFS). Secondary endpoints: objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety profile.
- Statistical analysis included hazard ratios (HR), confidence intervals (CI), and P-values, with adjustments for confounders.
Main Results:
- Anlotinib group showed significantly longer median PFS (5.3 months) and OS (15.6 months) compared to the apatinib group (3.53 months PFS, 7.6 months OS).
- Subgroup analysis indicated bone metastases significantly impacted PFS in both groups.
- Anlotinib group had a lower incidence of grade 3-4 adverse events (13.64%) compared to the apatinib group (31.65%).
Conclusions:
- Anlotinib demonstrates superior efficacy and a better safety profile than apatinib for advanced NSCLC.
- Anlotinib is particularly effective in patients with bone metastases and EGFR-negative status.
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