Anlotinib as Maintenance Therapy After First-Line Chemotherapy Combined with Consolidation Radiation for Extensive-Stage Small Cell Lung Cancer

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Abstract

Background

Small cell lung cancer is sensitive to chemotherapy and radiotherapy, but local recurrence and distant metastasis occur shortly after treatment. This study aimed to evaluate the real-world value of anlotinib as a maintenance therapy in patients with extensive-stage small cell lung cancer (ES-SCLC) after first-line chemotherapy and consolidative thoracic radiotherapy (CTRT).

Patients and Methods

A total of 150 patients with ES-SCLC treated with first-line chemotherapy and CTRT from April 2017 to December 2021 were retrospectively analyzed. After the completion of chemoradiotherapy, patients received anlotinib according to their desire. The primary endpoints were progression-free survival (PFS) and overall survival (OS) after the first diagnosis, and the secondary endpoints were prognostic factors and safety.

Results

The ORR and DCR of patients with ES-SCLC were 50.0% and 80.3%, respectively, in the anlotinib group and 42.9% and 69.0% in the no-maintenance therapy group. The 3-year OS rates were 27.6% and 12.6% in the anlotinib and observation groups (HR = 2.52, P = 0.003), and the median OS times were 23.8 months and 15.3 months. The 3-year PFS rates were 18.2% and 8.8% in the anlotinib and observation groups (HR = 1.76, P = 0.034) with median PFS times of 11.5 months and 8.8 months. After stratification on the basis of clinical response, patients who achieved CR plus PR after chemoradiotherapy had a longer median OS in the anlotinib and observation groups (34.0 months vs 24.8 months, HR = 2.40, P = 0.009). There were higher incidence rates of hand–foot syndrome (27.3% vs 10.5%, P = 0.001), gingival bleeding/hemoptysis (18.5% vs 4.8%, P = 0.015) and rash (33.3% vs 4.8%, P < 0.001) in the anlotinib group than in the observation group.

Conclusion

Maintenance therapy with anlotinib improved the survival of patients with ES-SCLC after first-line chemotherapy and CTRT. Owing to the small sample size of the real-world trial, the reliability of our study needs to be confirmed in more studies.

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Most cited references 31

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First-Line Atezolizumab plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer

Leora Horn, Aaron Mansfield, Aleksandra Szczęsna … (2018)

Enhancing tumor-specific T-cell immunity by inhibiting programmed death ligand 1 (PD-L1)-programmed death 1 (PD-1) signaling has shown promise in the treatment of extensive-stage small-cell lung cancer. Combining checkpoint inhibition with cytotoxic chemotherapy may have a synergistic effect and improve efficacy.

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Author and article information

Journal

Journal ID (nlm-ta): Technol Cancer Res Treat

Journal ID (iso-abbrev): Technol Cancer Res Treat

Journal ID (publisher-id): TCT

Journal ID (hwp): sptct

Title: Technology in Cancer Research & Treatment

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Print): 1533-0346

ISSN (Electronic): 1533-0338

Publication date (Electronic): 31 January 2025

Publication date Collection: 2025

Volume: 24

Electronic Location Identifier: 15330338251317571

Affiliations

[1 ]Department of Radiation Oncology, Ringgold 117747, universityYantai Yuhuangding Hospital, Qingdao University; , Yantai, P.R. China

[2 ]Department of Respiratory Medicine, Ringgold 117747, universityYantai Affiliated Hospital, Yantai Yuhuangding Hospital, Qingdao University; , Yantai, P.R. China

Author notes

[*]

These authors contributed equally to this work.

[*]Jie Song, Department of Respiratory Medicine, Yantai Yuhuangding Hospital, School of Medicine, Qingdao University, 20# Yuhuangding Dong Road, Yantai, 264000, P.R. China; Email: ytyhdyysj@ 123456163.com .

Author information

Jie Song https://orcid.org/0009-0000-1903-4794

Article

Publisher ID: 10.1177_15330338251317571

DOI: 10.1177/15330338251317571

PMC ID: 11786289

PubMed ID: 39887207

SO-VID: 559f80a8-5b9a-495e-8852-687c21c7b47d

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 16 July 2024

Date revision received : 28 November 2018

Date accepted : 17 January 2025

Custom metadata

typesetter ts19

cover-date January-December 2025

Keywords: small cell lung cancer,extensive stage,chemotherapy,consolidative radiotherapy,maintenance therapy,anlotinib

Data availability:

Keywords: small cell lung cancer, extensive stage, chemotherapy, consolidative radiotherapy, maintenance therapy, anlotinib