安罗替尼治疗晚期肺癌效果及安全性分析

Analysis on the efficacy and safety of anlotinib in patients of advanced lung cancers

目的:探讨安罗替尼在晚期肺癌的三线或三线以上治疗中的疗效及安全性。方法:回顾性收集芜湖市第二人民医院2018年1月~2020年6月接受三线或三线以上治疗的晚期肺癌患者为研究对象,共入组56例,安罗组接受安罗替尼治疗,对照组接受最佳支持治疗;结合治疗前后的影像学改变和治疗相关不良事件,探讨安罗替尼在晚期肺癌治疗的近期疗效、远期疗效和安全性的真实世界研究。结果:安罗组客观有效率(ORR)42.86%,疾病控制率(DCR)85.71%;安罗组中位无进展生存期(PFS)[8(4.628~11.372)月]长于对照组PFS[2(1.138~2.862)月](P<0.05)。且多因素Cox回归模型显示,对照组患者发生进展的风险是安罗组的2.666(1.261~5.639)倍(P<0.01)。安罗替尼常见不良反应为乏力、咯血、肝功能异常、高血压,总体可耐受。结论:对于肺癌的三线或以上治疗,安罗替尼的总体疗效较高,安全性良好,优于最佳支持治疗。在真实的晚期肺癌治疗中,临床上可考虑推荐安罗替尼用于晚期非小细胞肺癌和小细胞肺癌的三线或以上治疗。

Objective:To observe efficacy and safety of anlotinib as a third-line therapy or further treatment of patients with advanced lung cancer.Methods:Retrospective analysis was performed in 56 cases of advanced lung cancer undergone third-line therapy or further treatment in Wuhu No.2 People′s Hospital between January 2018 and June 2020.The cases were divided into anlotinib group and control group.Patients in the former group received anlotinib monotherapy,and those in the control group were given best supportive treatment.Then the short/long-term efficacies and safety of anlotinib were investigated on real-world evidence basis through examination of the imaging changes before and after therapy and medication-related adverse events.Results:The objective remission rate(ORR)and disease control rate(DCR)in anlotinib group was 42.86%and 85.71%,respectively.Patients in anlotinib group had longer median progression-free-survival(PFS)than those of that in control group[8 months,(4.628-11.372)months,vs.2 months,(1.138-2.862)months](P<0.05).Multivariate Cox regression analysis showed the hazard of progression in the control group was 2.666 times(ranging 1.261-5.639)of anlotinib group.Common adverse reactions in anlotinib group were associated with fatigue,hemoptysis,abnormal liver function,and hypertension,yet were almost tolerable.Conclusion:Monotherapy with anlotinib as third-line therapy or further treatment can lead to better overall efficacy and safety in patients of lung cancer,and is superior to the best supportive treatment.Therefore,anlotinib can be recommended as third-line therapy or further treatment of patients with advanced non-small cell lung cancer and small cell lung cancer in real-world treatment practice.