1 徐州医科大学附属医院肿瘤科，江苏 徐州 221006
目的：探讨盐酸安罗替尼治疗晚期非小细胞肺癌(non-small lung cancer，NSCLC)的临床疗效及不良反应。方法：回顾性分析2017年6月至2019年1月徐州医科大学附属医院收治的三线治疗及以上的晚期NSCLC，应用盐酸安罗替尼治疗的45例患者的临床资料，综合评价患者的疗效和无进展生存期(progression-free survival，PFS)以及不良反应情况。结果：共纳入45例患者，将患者分为安罗替尼单药组(24例)与安罗替尼联合用药组(21例)，其中联合白蛋白结合型紫杉醇化疗17例，联合纳武单抗免疫治疗4例。在45例患者中，部分缓解(partial remission，PR)占4.4%(2/45)，疾病稳定(stable disease，SD)占88.9%(40/45)，疾病进展(progressive disease，PD)占6.7%(3/45)，客观有效率(objective response rate，ORR)为4.4%，疾病控制率(disease control rate，DCR)为93.3%。45例患者的中位PFS为3.70个月，经log-rank检验结果显示不同治疗方案差异有统计学意义(P<0.05)。其中单药组患者中位PFS为3.30个月，联合用药组患者中位PFS为5.30个月，联合用药组PFS优于单药组。不良反应主要包括乏力、高血压、食欲不振、手足综合征等，其中3级不良事件包括高血压、手足综合征及骨髓抑制，未发现4级及以上的不良事件。结论：盐酸安罗替尼在三线治疗及以上的晚期NSCLC的治疗中，具有较好的疾病控制及生存获益，且不良反应相对可控。
Clinical observation of anlotinib hydrochloride in the treatment of advanced non-small cell lung cancer
This work was supported by Jiangsu Provincial Science and Education Strong Health Innovation Radiotherapy Project, China (CXTDA2017034).
Objective: To investigate the clinical efficacy and adverse reactions of anlotinib in the treatment of advanced non-small cell lung cancer (NSCLC). Methods: The clinical data of 45 patients with advanced non-small cell lung cancer who failed in multi-line treatment and poor tolerance to anti-tumor treatment in the affiliated Hospital of Xuzhou Medical University from June 2017 to January 2019 were analyzed retrospectively. The efficacy, progression-free survival (PFS) and adverse reactions of the patients were evaluated comprehensively. Results: A total of 45 patients were enrolled, including 24 cases in a single group and 21 cases in a combination group (17 cases combined with albumin-bound paclitaxel chemotherapy and 4 cases combined with nivolumab immunotherapy). Among the 45 patients, partial remission (PR) accounted for 4.4% (2/45), stable disease (SD) accounted for 88.9% (40/45), progressive disease (PD) accounted for 6.7%. The objective response rate (ORR) was 4.4%, and the disease control rate (DCR) was 93.3%. The median PFS of 45 patients was 3.70 months. The survival rate of patients with different treatment regimens and short-term effects was significantly different from that of patients with short-term efficacy (P<0.05). The results of log-rank test showed that there was significant difference in the survival rate of patients with different treatment regimens and short-term effects. The PFS in the single drug group was 3.30 months, and the PFS in the combination group was 5.30 months. The PFS in the combination group was better than that in the single drug group. The adverse reactions of 45 patients included hypertension, fatigue, thyroid dysfunction, hand and foot syndrome, and so on. The common adverse events of grade 3 included hypertension, myelosuppression and hand and foot syndrome. No adverse events of grade 4 or above were found in this study. Conclusion: Anlotinib has better disease control and survival benefits in advanced non-small cell lung cancer patients with failed second-line treatment, and the adverse reactions are relatively small.
anlotinib; advanced non-small cell lung cancer; anti-angiogenesis; targeted therapy; receptor