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Chen X, Wei X, Yao P, Liu Y, Guan H, Kang H, Liu D, Diao Y, Ma X, Min W, Shan C, Zhao Y, Zhao F, Chen Y, Xiao D, She Q, Liu Y, Zhang Y, Zhang S. The Efficiency and Toxicity Of Anlotinib in Combination With Docetaxel Followed by Epirubicin and Cyclophosphamide Regimen as Neoadjuvant Treatment in IIB to IIIA Triple Negative Breast Cancer: A Single-Arm, Multicenter, Open-Label, Phase II Study. Clin Breast Cancer 2024; 24:e195-e202. [PMID: 38670862 DOI: 10.1016/j.clbc.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/03/2023] [Accepted: 01/25/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND The combination of neoadjuvant chemotherapy and anti-angiogenesis therapy for patients with triple-negative breast cancer (TNBC) remains inadequately supported by evidence. We conducted a single-arm, open-label, multicenter, phase II trial to evaluate the efficacy and toxicity of anlotinib plus epirubicin and cyclophosphamide followed by paclitaxel in patients with IIB to IIIA stage TNBC. METHODS Newly diagnosed patients received epirubicin at 90 mg/m2 and cyclophosphamide at 600 mg/m2 followed by docetaxel at 100 mg/m2 (21 days per cycle; total of 4 cycles), along with oral anlotinib (12 mg qd, d1-14; 21 days per cycle; total of 4 cycles). Subsequently, patients underwent surgery. The primary endpoint of this study was pathologic complete response (pCR). RESULTS Among the 34 included patients, the median age was 46.5 years (range: 27-72); all were female. Pathological assessment revealed that 17 patients achieved RCB 0 response, which is currently defined as pathologic complete response; 3 patients achieved RCB 1; 12 patients achieved RCB 2; and 1 patient achieved RCB 3. The probability of a grade 3 adverse reaction was 17.6%, and no grade 4 adverse reactions occurred. The most common hematological adverse reaction was leukopenia (13/34, 38.2%), of which 5.9% (2/34) were grade 3. The most common non-hematological adverse reactions were oral mucositis (16/34, 58.8%), fatigue (50.0%), hand-foot syndrome (50.0%), hypertension (44.1%), bleeding (44.1%), and alopecia (32.4%). CONCLUSION The combination of anlotinib and EC-T chemotherapy demonstrated tolerable side effects in the neoadjuvant treatment of early TNBC. pCR was higher than what has been reported in previous clinical studies of chemotherapy alone. This study provides additional rationale for using anlotinib plus docetaxel-epirubicin-based chemotherapy regimen in patients with early-stage TNBCs.
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Affiliation(s)
- Xi Chen
- Xi'an Jiaotong University, Shaanxi Province, China
| | - Xinyu Wei
- Xi'an Jiaotong University, Shaanxi Province, China
| | - Peizhuo Yao
- Xi'an Jiaotong University, Shaanxi Province, China
| | - Yanbin Liu
- Xi'an Jiaotong University, Shaanxi Province, China
| | - Haitao Guan
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Huafeng Kang
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Di Liu
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Yan Diao
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Xiaobin Ma
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Weili Min
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Changyou Shan
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Yang Zhao
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Fang Zhao
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Yuanyuan Chen
- Baoji Central Hospital of Shaanxi Province, Shaanxi Province, China
| | - Dong Xiao
- 3201 Hospital of Hanzhong City, Shaanxi Province, China
| | - Qing She
- Baoji Central Hospital of Shaanxi Province, Shaanxi Province, China
| | - Youhuai Liu
- Baoji Central Hospital of Shaanxi Province, Shaanxi Province, China
| | - Yinbin Zhang
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China
| | - Shuqun Zhang
- The Second Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China.
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Cheng Y, Wu L, Huang D, Wang Q, Fan Y, Zhang X, Fan H, Yao W, Liu B, Yu G, Pan Y, Xu F, He Z, Dong X, Ma R, Min X, Ge X, Chen H, Liu Q, Hu Y, Liu Y, Yang C, Yang Y, Li X, Zhou L. Myeloprotection with trilaciclib in Chinese patients with extensive-stage small cell lung cancer receiving chemotherapy: Results from a randomized, double-blind, placebo-controlled phase III study (TRACES). Lung Cancer 2024; 188:107455. [PMID: 38224653 DOI: 10.1016/j.lungcan.2023.107455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 01/17/2024]
Abstract
INTRODUCTION Trilaciclib is a transient cyclin-dependent kinase 4/6 inhibitor that decreases the incidence of chemotherapy-induced myelosuppression in extensive-stage small cell lung cancer (ES-SCLC). TRACES study was designed to assess the safety, efficacy and pharmacokinetics (PK) of trilaciclib before chemotherapy in Chinese patients with ES-SCLC. METHODS The study included an open-label safety run-in part (Part 1) and double-blinded, placebo-controlled part (Part 2) where patients received trilaciclib or placebo before chemotherapy. Treatment-naïve or previously treated ES-SCLC patients received intravenous trilaciclib (240 mg/m2) or placebo before etoposide/carboplatin or topotecan, respectively. Primary endpoints were PK, safety and duration of severe neutropenia (DSN) in Cycle 1 in Part 1 and Part 2. Exploratory endpoints included the effect of trilaciclib on other myeloprotection endpoints, safety and antitumor efficacy. RESULTS Overall, 95 Chinese patients were enrolled, of which 12 and 83 patients were in Part 1 and Part 2, respectively. In Part 1, trilaciclib was well tolerated. Non-compartmental analysis results revealed no substantial differences in the main exposure parameters. In Part 2, 41 patients received trilaciclib, and 42 received placebo. Patients in trilaciclib arm vs placebo arm had a clinically and statistically significant decrease in DSN (mean [SD]) in Cycle 1 (0 [1.7] vs 2 [3.0] days; P = 0.0003), with improvements in additional neutrophil, red blood cell, and platelet measures. After a median follow-up of 14.1 months, the median overall survival was 12.0 months in trilaciclib arm and 8.8 months in placebo arm (HR, 0.69; 95 % CI: 0.40-1.22). Median progression-free survival was 4.8 months and 4.3 months, respectively (HR, 0.86; 95 % CI: 0.53-1.39). Trilaciclib had a well-tolerated safety profile. CONCLUSIONS Trilaciclib in the Chinese population demonstrated a similar PK and safety profile as seen in other global trials. There was significant reduction of DSN in Cycle 1, thereby substantiating the myeloprotective effects of trilaciclib in Chinese ES-SCLC patients.
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Affiliation(s)
- Ying Cheng
- Jilin Cancer Hospital, Changchun, China.
| | - Lin Wu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Dingzhi Huang
- Tianjin Medical University Cancer Hospital and Institute, Tianjin, China
| | - QiMing Wang
- Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China
| | - Yun Fan
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - XiQin Zhang
- Shandong Cancer Hospital & Institute, Jinan, China
| | - HuiJie Fan
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - BaoGang Liu
- Harbin Medical University Cancer Hospital, Harbin, China
| | - GuoHua Yu
- Weifang People's Hospital, Weifang, China
| | - YueYin Pan
- The First Affiliated Hospital of USTC, Hefei, China
| | - Fei Xu
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | | | - XiaoRong Dong
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rui Ma
- Liaoning Cancer Hospital, Shenyang, China
| | | | - XiaoSong Ge
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Hualin Chen
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Qun Liu
- The First Affiliated Hospital of Xiamen University, Xiamen, China
| | | | - Ying Liu
- Jilin Cancer Hospital, Changchun, China
| | - Chen Yang
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
| | - Yang Yang
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
| | - Xiucui Li
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
| | - Li Zhou
- State Key Laboratory of Neurology and Oncology Drug Development, Nanjing, China and Simcere Zaiming Medical Technology Co., Ltd, Beijing, China
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Wang M, Mao M, Yang Y, Cai Z, Li Y, Chen Y, Cai J, Ye Q. Safety and efficacy of anlotinib hydrochloride capsules in advanced non-small-cell lung cancer: a multicenter, real-world study. Future Oncol 2023; 19:1729-1739. [PMID: 37650748 DOI: 10.2217/fon-2023-0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Objective: To investigate the safety and efficacy of anlotinib hydrochloride capsules in stage III-IV non-small-cell lung cancer (NSCLC). Methods: NSCLC patients received anlotinib monotherapy or combination therapy. The primary end point was adverse reactions during anlotinib treatment and the secondary end point was progression-free survival. Results: During anlotinib treatement, 41.85% (167/399) of patients experienced adverse reactions, and the monotherapy group had a lower incidence than the combination group (36.89 vs 49.68%; p = 0.012). The median progression-free survival of patients in the monotherapy group was significantly lower than that in the combination group (5 vs 6 months; p = 0.0119). Conclusion: Compared with anlotinib monotherapy, combination therapy resulted in longer PFS and a higher incidence of adverse reactions in patients with NSCLC.
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Affiliation(s)
- Meng Wang
- Department of Oncology, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
| | - Mengxia Mao
- Department of Oncology, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
| | - Yonghua Yang
- Department of Oncology, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
| | - Zhiqiang Cai
- Department of Oncology, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
| | - Yan Li
- Department of Oncology, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
| | - Yuanyuan Chen
- Department of Oncology, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
| | - Jun Cai
- Department of Oncology, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
| | - Qingqing Ye
- Department of Breast Surgery, The First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, China, 434000
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Wang BC, Fu C, Lin GH. The efficacy of adebrelimab compared with durvalumab and atezolizumab in untreated extensive-stage small-cell lung cancer: a survival analysis of reconstructed patient-level data. Front Immunol 2023; 14:1185577. [PMID: 37215120 PMCID: PMC10196127 DOI: 10.3389/fimmu.2023.1185577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/24/2023] [Indexed: 05/24/2023] Open
Abstract
Background Adebrelimab showed excellent efficacy in the first-line treatment for extensive-stage small-cell lung cancer (ES-SCLC). However, whether adebrelimab is superior to durvalumab and atezolizumab remains unclear. Therefore, we, in this study, aimed to compare the survival data of adebrelimab (CAPSTONE-1 trial) with durvalumab (CASPIAN trial) and atezolizumab (IMpower133 trial) in the first-line setting of ES-SCLC patients. Methods Online databases, including PubMed, Embase, Web of Science, and Cochrane CENTRAL, were systematically searched on December 2, 2022. The metaSurvival and IPDfromKM methods were used to analyze the summary survival curves and the reconstructed patient-level data. The main endpoints were median overall survival (OS) and progression-free survival (PFS). Results In this analysis, survival data in the CASPIAN, IMpower133, and CAPSTONE-1 trials were collected from five published studies. The pooled median OS and PFS were 14.0 months (95% CI 11.2-16.6) and 5.6 months (95% CI 4.7-6.7) when ES-SCLC patients received chemotherapy (etoposide and cisplatin/carboplatin) and anti-PD-L1 therapy. Based on the reconstructed patient-level data, adebrelimab significantly prolonged survival outcomes against atezolizumab (OS: Hazard ratio [HR]0.76, 95% CI 0.60-0.95; PFS: HR 0.67, 95% CI 0.54-0.83) and durvalumab (OS: HR 0.75, 95% CI 0.60-0.92). Conclusion For previously untreated ES-SCLC patients, longer survival time might be benefited from adding adebrelimab to etoposide-platinum chemotherapy. In future studies, further real-world evidence or head-to-head clinical trials are warranted to confirm the differences between the PD-L1 inhibitors.
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Affiliation(s)
- Bi-Cheng Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Fu
- Department of Dermatology, Wuhan No.1 Hospital, Wuhan, China
| | - Guo-He Lin
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
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