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Anlotinib Plus Immune Checkpoint Inhibitors versus Chemotherapy in Elderly Patients with Extensive-Stage Small-Cell
Bing-Wei Lu1, Can Zhao2, Da-Zhong Wang3
1Department of general Medicine, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical University, Liaoning Cancer Hospital of Dalian University of Technology, Shenyang, Liaoning, People's Republic of China.
Anlotinib plus immune checkpoint inhibitors (ICIs) significantly improved overall survival for elderly extensive-stage small-cell lung cancer (ES-SCLC) patients compared to chemotherapy. The combination therapy showed comparable safety, offering a promising treatment option.
Area of Science:
- Oncology
- Pharmacology
- Geriatric Medicine
Background:
- Extensive-stage small-cell lung cancer (ES-SCLC) presents a significant therapeutic challenge, particularly in elderly populations.
- Current treatment paradigms for ES-SCLC often involve chemotherapy, with limited options for improving survival outcomes in older patients.
Purpose of the Study:
- To compare the real-world effectiveness and safety of anlotinib plus immune checkpoint inhibitors (ICIs) versus traditional chemotherapy in elderly patients with ES-SCLC.
- To evaluate key survival endpoints, including overall survival (OS) and progression-free survival (PFS), as well as response rates and tolerability.
Main Methods:
- Retrospective analysis of 119 elderly patients (≥65 years) with ES-SCLC.
- Observation Group (OG): 59 patients received anlotinib plus ICIs.
- Control Group (CG): 60 patients received single-agent chemotherapy. Survival data analyzed using Kaplan-Meier, Log rank tests, and Cox proportional hazards modeling.
Main Results:
- Anlotinib plus ICIs significantly improved median OS (11.9 vs. 6.7 months, P=0.003) and PFS (5.5 vs. 3.1 months, P=0.003) compared to chemotherapy.
- Higher objective response rate (ORR) (33.9% vs. 15.0%, P=0.016) and disease control rate (DCR) (79.7% vs. 55.0%, P=0.004) were observed in the anlotinib plus ICIs group.
- Grade ≥3 treatment-related adverse events were not significantly different between groups (42.4% vs. 55.0%, P=0.168), with common toxicities including fatigue, hypertension, and myelosuppression.
Conclusions:
- Anlotinib combined with ICIs demonstrates superior efficacy in terms of OS and PFS compared to single-agent chemotherapy in elderly patients with ES-SCLC.
- The combination therapy exhibits an acceptable safety profile, with manageable adverse events.
- These real-world findings suggest anlotinib plus ICIs as a promising therapeutic strategy for elderly ES-SCLC patients, warranting further investigation in prospective trials.
