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He Z, Zhou H, Wang J, Li D, Zhang X, Wang P, Ma T, Zhang Y, Tian C, Chen Y, Zou M, Han Y, Xu C, Ma S, Wang L, Wu X, Chen G, Wang Q. Apatinib with etoposide capsules as a third- or further-line therapy for extensive-stage small cell lung cancer: an open-label, multicenter, single-arm phase II trial. Transl Lung Cancer Res 2021; 10:889-899. [PMID: 33718030 PMCID: PMC7947412 DOI: 10.21037/tlcr-20-1235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Patients with extensive-stage small-cell lung cancer (ES-SCLC) have a particularly poor prognosis. And the treatment options for patients with relapsed or refractory ES-SCLC are limited. Thus, we conducted an open-label, multicenter, single-arm phase II clinical trial to assess the efficacy and safety of apatinib plus etoposide capsules as the third- or further-line treatment in ES-SCLC patients. Methods Patients with ES-SCLC who experienced disease progression following 2 to 3 previous therapies from 11 medical centers in China were enrolled to receive apatinib (250 mg/d, continuously) and etoposide capsules (50 mg/d, on day 1–21, per 28 days). The treatment continued until disease progression, treatment intolerance, or death. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were objective response rate (ORR), overall survival (OS), and safety. Results Fifty-six patients with relapsed or refractory ES-SCLC were enrolled from January 2018 to February 2020 and 53 of them were eventually included in the evaluation population. The median follow-up was 9.8 months. At the data cut-off time (March 5, 2020), 39 patients (74%) had died and 44 (83%) had progressed. The median PFS was 3.0 months (95% CI, 2.1–3.9) and the median OS was 5.0 months (95% CI, 3.6–6.4). No complete responses were seen. Eleven patients (21%) showed a best response of partial response and 37 (70%) patients achieved stable disease. The ORR was 20.8% (11/53), and the disease control rate (DCR) was 90.6% (48/53). The 6-month OS rate was 40.1% (95% CI, 26.2–54). After 12 months, the OS rate was 18.4% (95% CI, 4.7–32.1). Possible treatment-related grade III/IV adverse events included leukopenia [8 (15.1%)], neutropenia [7 (13.2%)], anemia [4 (7.4%)], and hand-foot syndrome [2 (3.8%)]. During the study, no mortality occurred as a consequence of treatment. Conclusions Apatinib combined with etoposide capsules exhibits efficacy and has an acceptable safety profile. It could be used as a later-line treatment for ES-SCLC patients who have been heavily pretreated with standard therapies. Further exploration of apatinib combined with etoposide capsules in phase III trials is warranted.
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Affiliation(s)
- Zhen He
- Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Hanqiong Zhou
- Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Junsheng Wang
- Department of Medical Oncology, Anyang Cancer Hospital, Anyang, China
| | - Ding Li
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Xudong Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Pengyuan Wang
- Department of Medical Oncology, Xuchang Central Hospital, Xuchang, China
| | - Tianjiang Ma
- Department of Medical Oncology, Luohe Central Hospital, Luohe, China
| | - Yueqiang Zhang
- Department of Medical Oncology, Zhoukou Chinese Medicine Hospital, Zhoukou, China
| | - Chuntao Tian
- Department of Medical Oncology, Sanmenxia Central Hospital, Sanmenxia, China
| | - Yunfang Chen
- Department of Medical Oncology, Zhumadian Central Hospital, Zhumadian, China
| | - Minglei Zou
- Department of Medical Oncology, The Second People's Hospital of Jiaozuo, Jiaozuo, China
| | - Yu Han
- Department of Medical Oncology, Jiyuan People's Hospital of Henan Province, Jiyuan, China
| | - Cong Xu
- Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuxiang Ma
- Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Lili Wang
- Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Xuan Wu
- Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Gongbin Chen
- Department of Medical Oncology, Shangqiu first People's Hospital, Shangqiu, China
| | - Qiming Wang
- Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
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