Efficacy of anlotinib in treatment of patients with advanced non-small cell lung cancer and its impact on prognosis
Objective To explore the efficacy of anlotinib in treatment of patients with advanced non-small cell lung cancer(NSCLC)and its impact on prognosis.Methods NSCLC patients with positive epidermal growth factor receptor(EGFR)or anaplasticlymphoma kinase(ALK),first-line chemotherapy failure,physical status(PS)score≤2 points,T790m-negative gene test result and stage ⅢB-Ⅳ treated in the Fourth Hospital of Qinhuangdao from July 2020 to December 2022 were selected as the subjects.According to the treatment methods,the patients were divided into the chemotherapy group(pemetrexed+carboplatin injection second-line chemotherapy regimen)and the anlotinib group(oral anlotinib+pemetrexed+carboplatin injection second-line chemotherapy regimen).The propensity score matching method(caliper=0.02)was used to exclude confounding factors such as gender and age,and 46 patients were obtained in each group.The solid tumor treatment effect(disease control rate(DCR),objective response rate(ORR))after 4 cycles of chemotherapy,the survival status(progression-free survival(PFS),overall survival(OS))and adverse drug reactions after 1 year of follow-up as well as the levels of serum tumor marker(cytokeratin 19 fragment antigen(CY-FRA21-1),neuron-specific enolase(NSE),carcinoembryonic antigen(CEA)),serum intercellular adhesion molecule-1(ICAM-1)and heat shock protein 90α(Hsp90α)before chemotherapy and after 4 cycles of chemotherapy were compared between the two groups.Results After 4 cycles of treatment,the DCR in the anlotinib group was significantly higher than that in the chemotherapy group(73.91%vs 52.17%)(χ2=4.665,P＜0.05),and the ORR was not significantly different from that in the chemotherapy group(43.48%vs 34.78%)(χ2=0.730,P＞0.05).After follow-up for 1 year,the PFS,the number of dead cases and OS in the chemotherapy group were(6.81±1.66)months,29 cases and(7.33±1.71)months and those in the anlotinib group were(8.17±2.32)months,19 cases and(10.56±1.84)months.The PFS(χ2=8.331,P＜0.05)and OS(χ2=8.394,P＜0.05)were significantly longer in the chemotherapy group than in the anlotinib group.During treatment,the incidence of proteinuria and hypertension was significantly higher in the anlotinib group than in the chemotherapy group(P＜0.05).The levels of serum tumor markers CY-FRA21-1,NSE and CEA and the levels of serum ICAM-1 and Hsp90α in both groups were significantly reduced after 4 treatment cycles(P＜0.05),and the levels were significantly lower in the anlotinib group((3.24±0.72)ng·mL-1,(16.65±3.07)ng·mL-1,(13.27±2.49)ng·mL-1,(0.56±0.11)ng·mL-1,(82.67±9.67)ng·mL-1)than in the chemotherapy group((3.88±0.84)ng·mL-1,(18.24±3.12)ng·mL-1,(16.57±2.51)ng·mL-1,(0.64±0.18)ng·mL-1,(89.57±9.24)ng·mL-1)(t=3.923,2.464,6.330,2.572,3.499,all P＜0.05).Conclusion Anlotinib has high efficacy in treatment of patients with advanced NSCLC because it can significantly control the disease development,prolong the PFS,improve the quality of life,and inhibit the tumor growth and metastasis.
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