Efficacy And Safety Of Anlotinib Versus Docetaxel In Advanced Non-small Cell Lung Cancer After First-line Treatment Failure

Objective:This study explores the efficacy and safety of anlotinib versus docetaxel for advanced non-small cell lung cancer(NSCLC)that failes first-line treatment,to evaluate the possibility of anlotinib for second-line treatment of advanced non-small cell lung cancer(NSCLC).Methods:This study collected 60 cases of patients with advanced NSCLC diagnosed and treated in the medical department of Yunnan Provincial Cancer Hospital from January 2018 to March 2020.All cases were screened according to the inclusion criteria and exclusion criteria,they were divided according to different clinical treatment options.There are three groups:20 patients in the monotherapy group of anlotinib,20 patients in the docetaxel monotherapy group,and 20 patients in the combined treatment group(anlotinib combined with docetaxel).Compare the clinical efficacy、survival time and adverse reactions of the three groups of different treatment options.Results:All 60 patients reached the end point of treatment,and the efficacy evaluation can be performed,including 20 cases in the anlotinib group,20 cases in the docetaxel group,and 20 cases in the combination group.The median PFS of the anlotinib group was 5.0 months[95%CI(3.91-6.08)],the median PFS of the docetaxel group was 2.0 months[95%CI(1.81-2.19)],the median of the combined group PFS was 4.2 months[95%CI(2.86-5.54)],the differences between the three groups were statistically significant(P<0.05).Through further comparison between groups,it was found that the median PFS of the anlotinib group and the docetaxel group were 5.0 months VS 2.0 months(P=0.001),and the median PFS of the combined group and the docetaxel group were 4.2 months vs 2.0 months(P=0.01).The median PFS comparison between the two groups was statistically significant(P<0.05),but the median PFS comparison between the anlotinib group and the combined group did not show the advantages of combination therapy(5.0 months vs 4.2 months,P=0.75).Anlotinib group:0 cases(0%)with complete response(CR),2 cases(10%)with partial response(PR),18 cases(90%)with stable disease(SD),0 cases(0%)with progression disease(PD),20 cases(100%)of disease control rate(DCR),2 cases(10%)with objective response rate(ORR),.Docetaxel group:0 cases(0%)with complete response(CR),4 cases(20%)with partial response(PR),4 cases(20%)with stable disease(SD),12 cases(60%)with progression disease(PD),8 cases(40%)of disease control rate(DCR),4 cases(20%)with objective response rate(ORR).Combined group:0 cases(0%)with complete response(CR),6 cases(30%)with partial response(PR),14 cases(70%)with stable disease(SD),0 cases(0%)with progression disease(PD),6 cases(30%)with 20 cases(100%)of disease control rate(DCR),objective response rate(ORR).None of the patients in the three groups showed complete remission.The SD,PD and DCR among the three groups were statistically significant(P<0.05),but their ORR ratio was not statistically significant(P>0.05).The median PFS(P=0.001)and DCR(P=0.000)of the three groups of patients were statistically significant,but ORR was not statistically significant(P=0.346).It may be related to the small number of cases.From the perspective of adverse reactions,the main adverse reactions of the anlotinib group and the combined group were 18 cases of fatigue(90%)vs 16 cases(80%),and the main adverse reactions of the docetaxel group were digestive tract reactions(nausea and vomiting)in 14 cases(70%).In this study,the adverse effects of anlotinib monotherapy were mild,and no increase in the incidence of adverse reactions was observed in combination with docetaxel.Conclusion:Anlotinib showed superiority and controllable toxicity compared with docetaxel for advanced non-small cell lung cancer patients who failed first-line treatment,which can provide a reference for later large-scale clinical trials.