Open Access
ARTICLE
Apatinib Monotherapy or Combination Therapy for Non-Small Cell Lung Cancer Patients With Brain Metastases
Jianping Xu, Xiaoyan Liu, Sheng Yang, Yuankai Shi
Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, P.R. China
Oncology Research 2020, 28(2), 127-133. https://doi.org/10.3727/096504019X15707896762251
Abstract
Apatinib, an oral small molecular receptor tyrosine kinase inhibitor (TKI) developed first in China, exerts antiangiogenic and antineoplastic function through selectively binding and inhibiting vascular endothelial growth
factor receptor 2 (VEGFR-2). In this study, we aimed to explore the efficacy and safety profile of apatinib
monotherapy, or combined with chemotherapy or endothelial growth factor receptor (EGFR)-TKI in heavily
pretreated non-small cell lung cancer (NSCLC) patients with brain metastases. We performed a retrospective
analysis for relapsed NSCLC patients with brain metastases from our institute, who received apatinib
(250 mg or 500 mg p.o. qd) monotherapy, or combination with EGFR-TKI or chemotherapy as second or
more line systemic therapy until disease progression or unacceptable toxicity occurred. The objective response
rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), median overall survival
(mOS), and safety were analyzed. A total of 26 eligible patients were included: 24 patients diagnosed with
adenocarcinoma, 2 with squamous carcinoma, and 14 patients harboring EGFR sensitizing mutations. The
mPFS and mOS were 4.93 (range, 0.27−32.91; 95% CI 3.64−6.22) and 14.70 (range, 0.27−32.91; 95% CI
0.27−43.60) months for the whole group. The ORR and DCR were 7.7% (2/26) and 69.2% (18/26) for the
entire lesions, and 7.7% (2/26) and 79.6% (20/26) for brain metastases, respectively. Compared with patients
who received apatinib monotherapy, patients who received apatinib combination treatment had more favorable
mPFS (11.77 vs. 2.27 months,
p<0.05) and mOS (24.03 vs. 6.07 months,
p<0.05). Treatment-related toxicities
were tolerable including grade 1/2 hypertension, hand-and-foot syndrome, fatigue, nausea, liver dysfunction,
myelosuppression, skin rash, and palpitation. In conclusion, apatinib exhibited high activity and good tolerance
for NSCLC patients with brain metastasis, and it might become a potential choice for metastatic brain tumors
in NSCLC patients.
Keywords
Cite This Article
Xu, J., Liu, X., Yang, S., Shi, Y. (2020). Apatinib Monotherapy or Combination Therapy for Non-Small Cell Lung Cancer Patients With Brain Metastases.
Oncology Research, 28(2), 127–133.