Efficacyandsafetyofsecond-lineirinotecancombinedwith Anlotinibinthetreatmentofsmallcelllungcancer

Background and objectives:Small cell lung cancer(SCLC)accounts for about 15%of all lung cancers,and is the leading cause of cancer death in men and the second leading cause of cancer death in women worldwide.The malignant tumor has a short doubling time and is sensitive to radiotherapy and chemotherapy,but the prognosis of patients with small cell lung cancer is poor,with a 5-year survival rate of less than 5%.Small cell lung cancer is often sensitive to initial treatment;However,most patients develop recurrent disease after initial treatment,often with other sites of metastasis.Unfortunately,few drugs have been approved as effective second-line treatments for small cell lung cancer.Topotecan is a standard second-line option,but has not been widely used in patients due to its modest efficacy and significant hematological toxicity.The irinotecan monotherapy regimen appears to have acceptable toxicity and significant palliative effects compared with other monotherapy regimens for second-line treatment of small cell lung cancer.Targeted therapies have also yielded some encouraging results in recent years.Anlotinib is an oral tyrosine polykinase inhibitor.At present,irinotecan combined with anlotinib in the second-line treatment of small cell lung cancer has been clinically used,but there is still a lack of prospective studies on this regimen at home and abroad,and the relevant articles are also few.Given the strong advantage of amlotinib in the third-line and post-line treatment of extensive small-cell lung cancer,is it possible to try amlotinib in combination with irinotecan in the second-line treatment of small-cell lung cancer?Will it play the same advantageous role?It’s worth finding out.Methods:In this study,a total of 29 patients with small cell lung cancer who were hospitalized in the Department of Oncology of the Second Affiliated Hospital of Nanchang University from January 2018 to January 2021 and who relapsed after first-line treatment and received second-line treatment with irinotecan combined with amlotinib were collected.Collecting patients before treatment,the sex,age,history of alcohol,tobacco,stage,ECOG score,first-line treatment,adverse reactions in the first-line treatment,recurrence or progress of time after a line plan,second-line use scheme,scheme of using the second line of adverse reactions and the time of disease progression,and judge according to the results of the CT,MRI and other imaging studies the existence of distant metastases in patients with lesions.The enrolled patients were followed up by telephone and outpatient service to understand their recurrence after treatment,progression-free survival and overall survival after second-line treatment.Results:At the end of follow-up,the median OS was not achieved and the median PFS was 4 months(95%CI,3.73-5.86).By single factor analysis for brain metastases,ECOG score,presence of extremities syndrome with progression-free surial(PFS)in patients with apparently related to P values were 0.002,0.001,0.026,including brain metastases,ECOG score is 2 points,and the Ann ROM stand for,united Iraq for not present extremities syndrome during treatment for small cell lung cancer patients the risk factors of PFS.According to multivariate analysis,ECOG score was an independent risk factor for patients with PFS,with P value of 0.027.The main side effects were hand-foot syndrome in 22 cases(75.9%),myelosuppression in 12 cases(41.3%),digestive tract reaction in 9 cases(31.0%),fatigue in 9 cases(31.0%)and abnormal liver function in 2 cases(2.9%).The above adverse reactions were tolerated by patients as a whole.Conclusion:Irinotecan combined with amlotinib has certain advantages in the second-line treatment of patients with small cell lung cancer,and the toxic side effects are generally tolerable and effectively controlled in patients.