Apatinib monotherapy may be a safe and effective option among patients with advanced non-small cell lung cancer (NSCLC) who have experienced disease progression after chemotherapy or targeted therapies, according to a study published in Thoracic Cancer.1

Previous studies have shown that apatinib, a selective oral tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor 2 (VEGFR-2), may confer an antiangiogenic effect and avoid multiple drug resistance gained for other chemotherapies and apatinib has demonstrated efficacy in the second-line setting for gastrointestinal cancers. 

For this study, researchers retrospectively analyzed the outcomes of 34 patients with advanced or recurrent NSCLC who were treated with daily apatinib 250 mg alone in the second- or third-line settings. Eligible patients had confirmed EGFR mutations or ALK rearrangements; patients with EGFR mutations had failed EGFR-TKI therapy or EGFR-TKI therapy plus chemotherapy. Patients underwent magnetic resonance imaging (MRI) or computed tomography (CT) scans at the end of the first cycle, then every 2 cycles or earlier if there were significant signs of progression.

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Fifteen patients had an EGFR mutation or amplification.

Results showed that the median progression-free survival was 4 months (95% CI, 0.3-7.7). Overall, 2 (5.88%) and 19 (55.88%) patients achieved partial response or stable disease, respectively, and the disease control rate was 61.76%.

Apatinib also demonstrated a tolerable toxicity profile. The most frequently reported adverse events (AEs) included grade 1 and 2 hypertension, hand-foot syndrome, proteinuria, and fatigue; no grade 3 to 4 AEs were observed, and no patients withdrew from the study because of AEs.

The authors concluded that “although the dose of 250 mg apatinib in a second‐line setting adopted in this study is not widely recommended, the safety and efficacy observed were promising.

Based on our results, it will be interesting to view further research of apatinib combined with chemotherapy in a first‐line setting for advanced NSCLC.”

Reference

  1. Liu Z, Ou W, Li N, Wang SY. Apatinib monotherapy for advanced non‐small cell lung cancer after the failure of chemotherapy or other targeted therapy [published online August 20, 2018]. Thorac Cancer. doi: 10.1111/1759-7714.12836