Clinical efficacy of immune checkpoint inhibitors combined with anlotinib in the treatment of advanced non-small cell lung cancer
Objective To investigate the efficacy and tolerability of immune checkpoint inhibitors(ICIs)combined with anlotinib as a subsequent-line treatment for patients with advanced non-small cell lung cancer(NSCLC).Methods Patients with advanced NSCLC who received three or more lines of treatment and were admitted to Anhui No.2 Provincial People's Hospital from December 2019 to December 2023 were selected and divided into a monotherapy group treated with anlotinib alone and a combination group treated with ICIs in combination with anlotinib,based on their treatment regimens.The therapeutic effects and adverse reactions between the two groups were compared using the response evaluation criteria in solid tumors.Results A total of 45 patients were included,with 25 cases in the monotherapy group and 20 cases in the combination group.With a median follow-up time of 11.9(3.0 to 26.0)months as of February 2024,the objective response rates(ORR)were 12.0%and 15.0%,and the disease control rates(DCR)were 80.0%and 90.0%in monotherapy group and combination group,respectively,and these differences were not statistically significant(P>0.05).Compared to the monotherapy group,patients in the combination group had longer median progression-free survival(PFS,6.40 months vs 3.00 months)and median overall survival(OS,10.20 months vs 6.30 months),with statistical significance(P<0.05).Multiple metastases and more than three lines of treatment were identified as independent risk factors for both PFS and OS in NSCLC patients,while the combination therapy of ICIs with anlotinib served as an independent protective factor.Serum levels of carcinoembryonic antigen,cytokeratin 19 fragment,and squamous cell carcinoma antigen levels were all reduced post-treatment compared to pre-treatment in both groups,with lower levels observed in the combination group compared to the monotherapy group(P<0.05).No severe adverse reactions occurred in both group.Conclusion The combination of ICIs with anlotinib as a subsequent-line treatment for advanced NSCLC can prolong patient survival with manageable safety.
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