1
|
Si X, Zhang L, Wang H, Zhang X, Wang M, Han B, Li K, Wang Q, Shi J, Wang Z, Cheng Y, Shi Y, Chen W, Wang X, Luo Y, Nan K, Jin F. Management of anlotinib-related adverse events in patients with advanced non-small cell lung cancer: Experiences in ALTER-0303. Thorac Cancer 2019; 10:551-556. [PMID: 30666799 PMCID: PMC6397894 DOI: 10.1111/1759-7714.12977] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/24/2018] [Accepted: 12/24/2018] [Indexed: 11/29/2022] Open
Abstract
Background Anlotinib is an oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor, fibroblast growth factor receptor, platelet‐derived growth factor receptor, and stem cell factor receptor (c‐Kit). In the phase III ALTER‐0303 trial (Clinical Trial Registry ID: NCT 02388919), anlotinib significantly improved overall survival versus placebo in advanced non‐small cell lung cancer patients who had received at least two previous chemotherapy and epidermal growth factor receptor/anaplastic lymphoma kinase targeted therapy regimens. This study summarized adverse event management in this trial. Methods Patients were randomized (2:1) to anlotinib or placebo up to progression or intolerable toxicity. Adverse events were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 and managed by investigators. Key strategies for preventing and managing the most common adverse events included patient education, supportive care, and dose modification. Results Between February 2015 and August 2016, 294 patients received anlotinib. A total of 170 (57.8%) patients received antihypertensive medications for hypertension, 53 (18.0%) patients received levothyroxine for hypothyroidism, 24 (8.2%) patients received fibrates for hypertriglyceridemia, 11 (3.7%) patients took cortisone cream for hand‐foot syndrome, and 38 (12.9%) patients received anti‐diarrheal medications for diarrhea. Dose reduction and drug discontinuation were required in 24 (8.16%) and 31 (10.54%) patients in the anlotinib group, respectively. Conclusion Anlotinb‐related adverse events could be controlled by patient education, prophylactic measures, early and active intervention, and dose modification.
Collapse
Affiliation(s)
- Xiaoyan Si
- Respiratory Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Li Zhang
- Respiratory Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Hanping Wang
- Respiratory Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Xiaotong Zhang
- Respiratory Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Mengzhao Wang
- Respiratory Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Baohui Han
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai, China
| | - Kai Li
- Department of Thoracic Oncology, Tianjin Medical University Cancer Hospital, Tianjin, China
| | - Qiming Wang
- Department of Internal Medicine, Henan Province Tumor Hospital, Zhengzhou, China
| | - Jianhua Shi
- Department of Oncology, Linyi City Tumor Hospital, Linyi, China
| | - Zhehai Wang
- Department of Internal Medicine-Oncology, Shandong Province Tumor Hospital, Jinan, China
| | - Ying Cheng
- Department of Thoracic Oncology, Jilin Province Tumor Hospital, Changchun, China
| | - Yuankai Shi
- Department of Medical Oncology, Chinese Academy of Medical Sciences Cancer Hospital, Beijing, China
| | - Weiqiang Chen
- Department of Pulmonary Medicine, Lanzhou Military General Hospital, Lanzhou, China
| | - Xiuwen Wang
- Department of Chemotherapy, Qilu Hospital, Shandong University, Jinan, China
| | - Yi Luo
- Department of Medical Oncology, Hunan Province Tumor Hospital, Changsha, China
| | - Kejun Nan
- Department of Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Faguang Jin
- Department of Respiratory Diseases, Tangdu Hospital, Xi'an, China
| |
Collapse
|