Retrospective Study On Efficacy And Safety Of Apatinib In The Treatment Of Advanced Lung Cancer

Objective: The present study was designed to observe the efficacy and safety of apatinib in the treatment of advanced lung cancer,to explore the efficacy and safety of apatinib in different doses of apatinib and the effect of the different therapeutic lines in apatinib.TO explore the efficacy and safety of apatinib in different status of EGFR mutation.To compare the efficacy and tolerance of apatinib alone and apatinib combined chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods: This study was a retrospective study,The data of patients with advanced lung cancer confirmed by pathology was collected from the Department of Oncology of the first Hospital of China Medical University between 2013 to 2017.The hematological indexes,the status of EGFR mutation and pathological types of lung cancer of patients were collected before treatment.Drug toxicity,The line of therapy,Dose intensity of apatinib,short-term effect and long-term survival were recorded.Result: 70 patients with advanced lung cancer received apatinib were enrolled in the study.There were 58 NSCLC patients(82.86%)and 12 SCLC patients(17.14%)?In these NSCLC patients,there were 38 patients(65.52%)in Apatinib group and 20patient(34.48%)in Apatinib combined chemotherapy group.All of the 70 patients were included in the survival analysis.The overall median TTP of advanced lung cancer patients is 2 months(95%CI 1.414-2.586),and the median TTP of NSCLC patients is 2months(95%CI 1.3-2.7).The median TTP of SCLC patients is 2 months(95%CI0-4.263).Compared with SCLC,The median TTP of NSCLC patients was not significantly prolonged(P = 0.807).The overall response rate(ORR)was 4.3% and the disease control rate(DCR)was 72.9%.The objective remission rate was 8.33% and the disease control rate was 75%(9 cases)in the small cell lung cancer group.In non-small cell lung cancer group,the objective remission rate was 3.45% and the disease control rate was 74.14%.In terms of the response rate,there was 1 patient(2.63%)in apatinib alone group and 1patient(5.00%)in apatinib combined with chemotherapy group.In terms of disease control rate,there were 28 patients(73.68%)in apatinib alone group and 15(75.00%)inapatinib combined with chemotherapy group.Compared with apatinib group,the apatinib combined chemotherapy did not bring significant benefits(P=0.913).The results of survival analysis showed that compared with the apatinib alone group,the TTP of apatinib combined chemotherapy group was longer than that of apatinib group.(2month 95% CI 0.078-5.922 vs 3months,95%CI 1.010-2.990,P=0.028).Apatinib combined chemotherapy group significantly prolonged the median TTP time.Apatinib dose intensity and efficacy analysis showed that 49 patients(70.00%)were treated with low-dose intensity(<500 mg)of apatinib,16patients(22.86%)were treated with medium dose intensity(500 mg-749 mg),and high dose intensity(?750 mg)were applied in 5 patients(7.14%).there was no significant difference in TTP between different dose intensity group(P = 0.450).The analysis of the line of therapy and the curative effect showed that there was no significant difference between the two groups.There was no significant difference in TTP between the two groups.The analysis of the status of EGFR mutation and the curative effect showed that 17 patients(24.29%)in the type of EGFR mutation,51 patients(72.86%)are wild type.Compared with the all of 70 advanced lung cancer patient.The group of EGFR mutation don't significantly prolong the median TTP time(P=0.951).In the patient of NSCLC,compared with the group of wild type,The group of EGFR mutation don't significantly prolong the median TTP time(P=0.808).In terms of adverse reactions,apatinib group showed hypertension,Gastrointestinal reaction and proteinuria,apatinib combined chemotherapy group were mainly showed gastrointestinal reaction,diarrhea and hypertension.Most of them were ranked as grade I-II,which could be controlled by treatment.Conclusion: In advanced lung cancer patient,apatinib has a positive effect on all types of lung cancer,Compare with apatinib group the apatinib combined chemotherapy can significantly improve the TTP of NSCLC patients.The line of therapy and the status of EGFR mutation had no significant effect on the curative effect.