173P - Apatinib plus S-1 showes encouraging response in advanced non-small-cell lung canceras as laterline chemotherapy
- Zhiyong Wu (CN)
- Jianyu Wu (CN)
- Zhiyong Wu (CN)
Abstract
Background
There is no standard treatment strategy for patients with advanced non-small cell lung cancer (NSCLC) who experienced progression with three or more lines of chemotherapy. Apatinib, a new tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2 (VEGFR-2), has been shown confirming antitumor activity and manageable toxicities in breast and gastric cancers. Clinical trials of apatinib on non-small cell lung cancer show that progression-free survival is improved, but the objective response rate is still low. However, it remains to be explored whether the combined treatment of apatinib plus S1 could be further effective on NSCLC.
Methods
Effects of apatinib, S-1 and apatinib plus s-1 were assessed on two NSCLC cell lines (adenocarcinoma A549 and squamous carcinoma NCI-H520) and xenograft model by injecting NCI-H520 cells. Furthermore, we retrospectively assessed the efficacy and safety of apatinib plus S1 in 12 patients with advanced NSCLC after the failure of second or third-line chemotherapy.
Results
Apatinib plus S-1 strengthened the effect of S-1 and apatinib alone on the NSCLC cell lines, and NCI-H520 was more susceptible. Co-administration delayed the tumour growth than mono-therapy in the xenograft model. There were 12 patients available for efficacy and safety evaluation. 4/12 (33%) patients experienced dose reduction during treatment. Followed up to Dec 20, 2017, the median during time of treatment was 3.5 months. According to RECIST criteria, the disease control rate was 83%, 10/12 (partial response 50%, 6/12 and stable disease 33%, 4/10). Patients with lung squamous cell carcinoma could benefit more than those with lung adenocarcinoma (partial response 100%, 3/3 vs 33%, 3/9). The most frequent treatment-related adverse events were secondary hypertension (41.6%, 5/12), oral mucositis (50%, 6/12), hand-foot syndrome (33%, 4/12) and fatigue (33%, 4/12). Main grade 3 or 4 toxicities were hypertension (16.6%, 2/12), oral mucositis (8.3%, 1/12) and fatigue (8.3%, 1/12).
Conclusions
Apatinib plus S1 exhibits superior activity and acceptable toxicity for the heavily pretreated patients with advanced non-small cell lung cancer. Patients with lung squamous cell carcinoma could benefit more from this treament.
Legal entity responsible for the study
Chinese Peoples Liberation Army General Hospital
Funding
Has not received any funding
Disclosure
All authors have declared no conflicts of interest.
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