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Apatinib for chemotherapy-refractory extensive-stage SCLC: a retrospective study

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Abstract

Purpose

There is no standard treatment strategy for patients with extensive-stage small cell lung cancer (SCLC) who have failed two or more prior chemotherapeutic regimens. In this study, we retrospectively evaluated the efficacy and safety of apatinib in patients with extensive-stage SCLC after failure of more than second-line chemotherapy.

Methods

A study group comprised of 22 patients with extensive-stage SCLC after failure of more than two prior chemotherapeutic regimens was given apatinib orally at an initial dose of 500 mg daily until disease progression or unacceptable toxicity. This study was analyzed according to the National Cancer Institute Common Toxicity Criteria for adverse events (AEs) and Response Evaluation Criteria in Solid Tumors (RECIST) for response assessment.

Results

Between August 30, 2015, and May 26, 2017, 22 patients were enrolled for evaluating the efficacy and safety of apatinib. Among them, 12/22 (54.5%) underwent dose reduction during treatment. Up to July 31, 2018, the median progression-free survival rate was 135.0 days [95% confidence interval (CI) 63.8–206.2]. According to the RECIST criteria, the disease control rate (DCR) was 86.4%, 19/22 [comprised of partial response (PR) 18.2%, 4/22; and stable disease (SD) 68.2%, 15/22 patients]. The most frequent AEs were hand–foot syndrome (45.5%, 10/22), secondary hypertension (45.5%, 10/22) and fatigue (40.9%, 9/22). The primary grade 3 or 4 toxicities were hypertension (22.7%, 5/22), hand–foot syndrome (13.6%, 3/22), and proteinuria (9.1%, 2/22).

Conclusions

Apatinib exhibits modest activity and acceptable toxicity for patients with heavily pretreated extensive-stage SCLC.

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Acknowledgements

This work is supported by Grants from the National Natural Science Foundation of China (31500705), the Natural Science Foundation of Zhejiang Province (LY15H160006, LY17H160040) and Zhejiang Medical technology program (2016KYB035, 2016KYB037).

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  1. Hui Li and Jian Zeng are co-first authors.

Authors and Affiliations

  1. Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, 310022, China

    Hui Li, Xiangyu Jin, Xinmin Yu & Wei Hong

  2. Department of Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, 310022, China

    Jian Zeng

  3. Department of Laboratory Medicines, Zhejiang Cancer Hospital, Hangzhou, 310022, China

    Guoming Zhou

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  1. Hui Li
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Correspondence to Wei Hong.

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Li, H., Zeng, J., Jin, X. et al. Apatinib for chemotherapy-refractory extensive-stage SCLC: a retrospective study. Cancer Chemother Pharmacol 83, 1083–1090 (2019). https://doi.org/10.1007/s00280-019-03823-4

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