An Analysis Of The Efficacy And Safety Of Anlotinib In The Maintenance Therapy Of Advanced Non-small Cell Lung Cancer

Objective:In this study,we retrospectively analyzed the efficacy and safety of anlotinib in maintenance therapy for advanced non-small-cell lung cancer(NSCLC)after first-line platinum-containing dual agents combined with recombinant human endostatin(Endostatin),and explored the factors that might influence the prognosis.Methods:The patients with advanced NSCLC who have recieve 4-6 cycles of first-line platinum-containing chemotherapy combined with recombinant human endothelial angiostatin(endostatin)for 4-6 cycles after which was assessed as complete response(CR),partial response(PR),and stable deasease(SD)in our hospital from June 2018 to July 2020 were selected as the research objects.They were divided into anlotinib group and control group based on whether allotinib was used as maintenance therapy.There were 52 patients and 41 patients respectively.After first-line chemotherapy,the anlotinib group was treated with anlotinib and the control group was checked regularly.Patients were followed up and progression-free survival(PFS),overall survival(OS)and adverse events were compared between the two groups.The Kaplan-Meier method was used to draw the survival curve,the log-rank method was used to test the difference in survival,and the Cox regression model was used for multivariate analysis.The difference was statistically significant with P<0.05.ResultsAnlotinib maintenance therapy can significantly prolong the PFS(7.1 months vs3.4 months,P=0.004)and OS(16.3 months vs 12.2 months,P=0.041)in patients with advanced NSCLC.In terms of safety,adverse reactions can be tolerated.Two cases of grade 3 adverse reactions occurred in the anlotinib group,one case was hypertension,which was relieved after treatment with ACEI antihypertensive drugs and dose reduction,and the other case was hand-foot skin reaction,the symptom was relieved after topical application of hormone ointment and dose reduction.There was no significant difference in the incidence of total adverse reactions and grade 3/4adverse reactions between the two groups(P>0.05).In terms of survival impact,univariate analysis revealed no pleural effusion(6.8 months vs 4.2 months,P=0.29),normal CEA level(6.6 months vs 4.2 months,P=0.005),and anlotinib group patients(7.1 months vs 3.4 months,P=0.005)had longer PFS.After multi-factor adjustment,anlotinib maintenance trerapy and normal CEA level were independent protective factors affecting PFS(HR=0.473,95%Cl: 0.277-0.807,P=0.006;HR=0.395,95%Cl:0.204-0.765,P=0.006);Patients with a ps score of 0-1(14.3 months vs 10.4 months,P=0.048),The number of distant metastases is less than 2(16.3 months vs 10.4months,P=0.015),no pleural effusion(14.3 months vs 10.3 months,P=0.004),CEA normal level(14.3 months vs 10.5 Months,P=0.004)and the patients in the anlotinib group(16.3 months vs 12.2 months,P=0.045)had longer OS.After multi-factor adjustment,anlotinib maintenance therapy and PS score were 0-1 were independent protective factors affecting OS(HR=0.365,95%Cl: 0.190-0.700,P=0.002;HR=0.044,95%Cl: 0.270-0.905,P=0.022).Conclusions:1.Anlotinib maintenance therapy for patients with advanced NSCLC after the first-line platinum-containing dual-drug combined with recombinant human endostatin(Endostat)treatment can significantly prolong the PFS and OS of the patients,indicating that continuous anti-angiogenic therapy can bring survival benefits to patients,it has high safety and can be tolerated by most patients.2.Maintenance therapy with anlotinib and normal CEA levels are independent protective factors that affect patients’ PFS.Maintenance therapy with Anlotinib and a PS score of 0-1 are independent protective factors that affect patients’ OS.