Anlotinib or platinum-pemetrexed as second-line therapy in EGFR T790M-negative lung cancer.
BACKGROUND
Clinical management of T790M-negative patients after first-line epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) treatment failure is controversial. Anlotinib is a novel multi-target TKI for tumor angiogenesis and tumor cell proliferation, and it has been approved as a thirdline or beyond treatment for advanced non-small cell lung cancer (NSCLC). The impact of anlotinib as a second-line therapy compared with platinum-pemetrexed chemotherapy in T790M-negative patients after first-line EGFR-TKIs failed remains unclear.


METHODS
In this retrospective cohort study, we reviewed 20 patients who were given anlotinib and 42 patients who received platinum-pemetrexed chemotherapy as a control after first-line EGFR-TKIs therapy progression. All the patients were confirmed to be T790M-negative using the cobas EGFR Mutation Test. The primary end point included progression-free survival (PFS) time, objective response rate (ORR) and disease control rate.


RESULTS
The duration of PFS was significantly longer in the platinum-pemetrexed group than in the anlotinib group (median, 4.5 vs. 3.0 months; HR, 1.972; 95% CI, 1.078 to 3.607; P=0.021). The response rate was significantly better in the platinum-pemetrexed group (30.9%) than that in the anlotinib group (15%), and disease control rate (DCR) of both groups was 70% and 83%, respectively. All the adverse events in anlotinib group appeared to be manageable.


CONCLUSIONS
Anlotinib was less effective than platinum-pemetrexed chemotherapy in T790M-negative NSCLC patients after disease progression with first-line EGFR-TKIs therapy failure.
['Zhong|Run-Bo|RB|', 'Xu|Jian-Lin|JL|', 'Lou|Yu-Qing|YQ|', 'Chu|Tian-Qing|TQ|', 'Zhong|Hua|H|', 'Han|Bao-Hui|BH|']
D000971:Antineoplastic Combined Chemotherapy Protocols D002289:Carcinoma, Non-Small-Cell Lung D066246:ErbB Receptors D006801:Humans D007211:Indoles D008175:Lung Neoplasms D009154:Mutation D000068437:Pemetrexed D010984:Platinum D047428:Protein Kinase Inhibitors D011804:Quinolines D012189:Retrospective Studies
anlotinib epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) Non-small cell lung cancer (NSCLC) chemotherapy