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Zhou M, Chen X, Zhang H, Xia L, Tong X, Zou L, Hao R, Pan J, Zhao X, Chen D, Song Y, Qi Y, Tang L, Liu Z, Gao R, Shi Y, Yang Z. China National Medical Products Administration approval summary: anlotinib for the treatment of advanced non-small cell lung cancer after two lines of chemotherapy. Cancer Commun (Lond) 2019; 39:36. [PMID: 31221221 PMCID: PMC6585030 DOI: 10.1186/s40880-019-0383-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/13/2019] [Indexed: 12/30/2022] Open
Abstract
Background On May 8, 2018, the China National Medical Products Administration (NMPA) approved anlotinib, an orally administered anti-angiogenesis inhibitor, for the treatment of patients with advanced non-small cell lung cancer (NSCLC) who have progressed after treatment with two or more lines of prior systemic chemotherapy. Main body of the abstract China NMPA reviewed and inspected a regional double-blinded, placebo-controlled, Phase III trial comparing the overall survival (OS) of NSCLC patients between the anlotinib and placebo arms. A total of 437 patients were randomized (2:1) to receive either anlotinib (n = 294) or placebo (n = 143) once daily on a 2-week on and 1-week off schedule. Patients with epidermal growth factor receptor (EGFR) or activating anaplastic lymphoma kinase (ALK) genomic tumor aberrations should have disease progression on NMPA-approved therapy. Anlotinib is the first NMPA-approved drug for patients with advanced NSCLC who have progressed on at least two lines of prior systemic chemotherapies in China. The approval was based on a statistically and clinically significant improvement in median OS with anlotinib (9.46 months) compared with placebo [6.37 months; hazard ratio (HR]) = 0.70, 95% confidence interval (CI) = 0.55–0.89; two-sided log-rank P = 0.002]. The confirmed objective response rate (ORR) was 9.2% in the anlotinib arm and 0.7% in the placebo arm. The median duration of response (DoR) was 4.83 months, with a 95% CI of 3.31–6.97 months. The toxicity profile of anlotinib was consistent with that of known anti-angiogenesis inhibitors. Common adverse drug reactions (ADRs) in anlotinib-treated patients included hypertension (67.4%), hand–foot syndrome (43.9%), hemoptysis (14.0%), thyroid stimulating hormone (TSH) elevation (46.6%), and corrected QT interval (QTc) prolongation (26.2%). Short conclusion Anlotinib demonstrated a clinically significant OS prolongation as a novel therapeutic option for advanced or metastatic NSCLC following at least two lines of chemotherapy.
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Affiliation(s)
- Ming Zhou
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Xiaoyuan Chen
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Hong Zhang
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Lin Xia
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Xin Tong
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Limin Zou
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Ruimin Hao
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Jianhong Pan
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Xiao Zhao
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Dongmei Chen
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Yuanyuan Song
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Yueli Qi
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Ling Tang
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Zhifang Liu
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China
| | - Rong Gao
- Center for Drug Inspection, China National Medical Products Administration, Beijing, 100037, P. R. China
| | - Yuankai Shi
- Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, P. R. China
| | - Zhimin Yang
- Medical Review Department 1, Center for Drug Evaluation, China National Medical Products Administration, No. 128 Jianguo Road, Chaoyang District, Beijing, 100022, P. R. China.
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