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Prognostic factors of refractory NSCLC patients receiving anlotinib hydrochloride as the third-or further-line treatment

引用

Cancer Biology & Medicine 2018年第4期15卷 443-451页

作者： Jing Wang Yizhuo Zhao Qiming Wang Li Zhang Jianhua Shi Zhehai Wang Ying Cheng Jianxing He Yuankai Shi Hao Yu Yang Zhao Weiqiang Chen Yi Luo Xiuwen Wang Kejun Nan Faguang Jin Jian Dong Baolan Li Zhujun Liu Baohui Han Kai Li Department of Pulmonary Oncology Tianjin Medical University Cancer Institute and Hospital Department of Respiratory Medicine Shanghai Chest Hospital Department of Medical Oncology Henan Province Tumor Hospital Department of Respiratory Medicine Peking Union Medical College Hospital Department of Medical Oncology Linyi Cancer Hospital Department of Internal Medicine Shandong Cancer Hospital Department of Thoracic Oncology Jilin Cancer Hospital Department of Thoracic Surgery The First Affiliated Hospital of Guangzhou Medical University Department of Medical Oncology Cancer Hospital Chinese Academy of Medical Sciences Department of Biostatistics School of Public Health Nanjing Medical University Department of Respiratory Medicine Lanzhou Military General Hospital Department of Head and Neck Oncology Hunan Cancer Hospital Department of Chemotherapy Qilu Hospital of Shandong University Department of Medical Oncology The First Affiliated Hospital of Xi'an Jiaotong University Department of Respiratory and Critical Diseases Tang Du Hospital Department of Oncology Yunnan Cancer Hospital General Department Capital Medical University Beijing Chest Hospital

Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard chemotherapy.This study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the treatment.Methods:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo groups.Kaplan–Meier analysis and log-rank test were performed to compare PFS and OS.Cox proportional hazards model was adopted for multivariate prognostic analysis.Results:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for PFS.Meanwhile,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of PFS.High posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of OS.Conclusions:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were then identified.

关键词： Non-small cell lung cancer anlotinib third- or further-line therapy prognostic factor analysis

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