Anlotinib Safe, Effective as Third- or Later-line Treatment for Refractory SCLC

Findings from a real-world study suggest that anlotinib is safe and effective for treating refractory small-cell lung cancer (SCLC) in a third- or further-line setting, especially in patients without liver metastasis and with better physical status, with manageable adverse effects (AEs; J Cancer Res Clin Oncol. 2021. doi:10.1007/s00432-021-03848-4).

Anlotinib, a novel antiangiogenic multi-target tyrosine kinase inhibitor that has recently been approved in China, has demonstrated anticancer efficacy and acceptable safety in clinical trials for the treatment of SCLC.

Xuetian Gao, MD, Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong Province, China, and colleagues conducted a retrospective study evaluating the efficacy and safety of anlotinib as third- or further-line treatment in patients with refractory SCLC.

This study analyzed the clinicopathological data, treatment information, survival data and safety data of 40 patients with refractory SCLC who were treated with anlotinib monotherapy. Survival curves and univariate analysis were done using the Kaplan–Meier method and log-rank testing, respectively.

The patients in this study had extensive-stage SCLC or progressive limited-stage SCLC and received anlotinib monotherapy as third- or further-line treatment from July 2018 to June 2020. Among the 40 patients included in this study, 4 achieved partial response, 14 achieved stable disease, 22 experienced progressive disease, and no complete response was recorded in this group.

The disease control rate was 45.0%. The median progression-free survival (PFS) was 3 months, and the median overall survival (OS) was 7.8 months. Common AEs experienced by participants included hypertension, fatigue, anorexia, cough, rash and nausea. In 3 patients, grade 3 treatment-relapsed AEs occurred. 

Results from the Univariate analysis showed that patients without liver metastases, previously treated with radiotherapy or with Eastern Cooperative Oncology Group (ECOG) scores of 0 or 1 had longer OS with anlotinib treatment. Results from the Cox regression analysis showed that patients without liver metastases and patients with ECOG score ≤1 had longer PFS, while patients without liver metastases had longer OS.

“Anlotinib is beneficial to refractory SCLC as third- or further-line treatment, especially in patients without liver metastasis and with better physical status,” concluded Dr Gao and colleagues, adding, “Related adverse effects are tolerable and manageable.”