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Hand-foot syndrome and survival in patients with advanced non-small-cell lung cancer receiving anlotinib: a subgroup analysis of data from the ALTER 0303 study

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Abstract

Background

The ALTER 0303 study showed that anlotinib can significantly improve overall survival (OS) compared with the placebo in advanced non-small-cell lung cancer (NSCLC). Hand-foot syndrome (HFS) is a common anlotinib-related adverse event. The aim of this study was to assess the association of HFS with clinical benefit.

Methods

A subgroup analysis of patients treated with anlotinib from the ALTER 0303 study was performed. Our analysis assessed if the appearance of anlotinib-related HFS in the first 42 days (second-cycle HFS) and at any time could produce better clinical benefits.

Results

In this study, 294 patients were treated with anlotinib. Of which, 129 patients had HFS at any time, and 76 patients developed HFS in the first 2 cycles. Patients who received anlotinib and developed HFS had significantly prolonged OS, progression-free survival (PFS) compared to those who did not develop HFS in the first 2 cycles (13.5 vs 8.7 months, p = 0.001; adjusted hazard ratio (HR) 0.63 (95% confidence interval [CI] 0.44–0.89), p = 0.009; 5.8 vs 4.5 months, p = 0.001; adjusted HR, 0.59 [0.43–0.81], p = 0.001). The significant OS and PFS benefits for patients with HFS versus without were seen at any time (14.5 vs 7.3 months, p = 0.000; adjusted HR, 0.50 [0.36–0.67], p = 0.000; 5.8 vs 4.2 months, p = 0.000; adjusted HR, 0.49 [0.37–0.65], p = 0.000). In addition, the grade of severity of HFS was strongly correlated with OS (p = 0.000).

Conclusion

Presence of HFS may be a potential clinical marker for the treatment of NSCLC with anlotinib.

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Author information

Authors and Affiliations

  1. Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong, China

    Xueli Nan, Chao Xie, Jianjun Zhang, Shuai Fu, Xiao Han & Jie Liu

  2. Department of Oncology, Wu Di People Hospital, Shandong, China

    Xueli Nan

  3. Department of Oncology, Shandong Cancer Hospital and Institute, Shandong, China

    Chao Xie, Qingqing Zhu, Jianjun Zhang, Shuai Fu, Xiao Han, Qiujing Zhang & Jie Liu

  4. School of Medicine and Life Sciences, University of Ji’nan-Shandong Academy of Medical Sciences, Shandong, China

    Qingqing Zhu & Qiujing Zhang

  5. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai, China

    Baohui Han

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  1. Xueli Nan
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Contributions

Study concept and design: JL, CX, XN. Acquisition, analysis, or interpretation of data: XN, CX, QZ, JZ, SF. Drafting of the manuscript: JL, XN, QZ, JZ, QZ. Critical revision of the manuscript for important intellectual content: JL, CX. Statistical analysis: XN, CX, SF, XH, QZ. Administrative, technical, or material support: JL, BH. Study supervision: JL, BH, CX.

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Correspondence to Jie Liu.

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Nan, X., Xie, C., Zhu, Q. et al. Hand-foot syndrome and survival in patients with advanced non-small-cell lung cancer receiving anlotinib: a subgroup analysis of data from the ALTER 0303 study. Int J Clin Oncol 25, 1492–1498 (2020). https://doi.org/10.1007/s10147-020-01683-0

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  • DOI: https://doi.org/10.1007/s10147-020-01683-0

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