Anlotinib combined with whole-brain radiotherapy in non-small cell lung cancer with multiple brain metastases that progressed or developed after at least one lines of prior treatment

Frontiers in Oncology

Oncology

Shaorong Yu¹  Jun Zhu²  Xia He²  Lijun Zhao²  Ming Jiang²  Pudong Qian²  Jing Wen²  Jianfeng Wu²  Xiangzhi Zhu²  Cheng Kong²  Jianhua Xu²  Xue Song²  Zhen Guo³ 

[1] Department of Medical Oncology, Jiangsu Cancer Hospital and Nanjing Medical University Affiliated Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China;Department of Radiation Oncology, Jiangsu Cancer Hospital and Nanjing Medical University Affiliated Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China;Department of Radiology, Jiangsu Cancer Hospital and Nanjing Medical University Affiliated Cancer Hospital and Jiangsu Institute of Cancer Research, Nanjing, China;

关键词: non-small cell lung cancer;    brain metastases;    later-line;    whole-brain radiotherapy;    antiangiogenic TKIs;   

DOI  :  10.3389/fonc.2023.1169333

 received in 2023-02-19, accepted in 2023-08-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundIntracranial metastasis that failed standard systematic treatment is common in advanced non-small cell lung cancer (NSCLC), contributing significantly to morbidity and mortality. The aim of this study was to evaluate the efficacy and safety of anlotinib combined with whole-brain radiotherapy (WBRT) for NSCLC with brain metastases (BMs) that progressed or developed after at least one line of prior treatment and compare the outcomes with that of the contemporary institutional control.MethodsNSCLC patients with multiple BMs that progressed or developed after at least one line of prior systematic treatment and treated with WBRT subsequently between 2019 and 2021 were selected retrospectively for analysis. Based on whether concurrent anlotinib had been used in combination with WBRT, the cases were divided into the anlotinib group and control group. The primary endpoints were intracranial progression-free survival (iPFS) and safety.ResultsA total of 76 patients met the inclusion criteria of the study. Of the 76 patients, 34 received concurrent WBRT and anlotinib followed by anlotinib maintenance and 42 were treated with WBRT alone or in combination with other systemic agents at the physicians’ discretion. The median follow-up for the entire cohort was 21 months. The median iPFS for the anlotinib and control group was 6.7 months (95% CI, 4.6–9.9) and 5.3 months (95% CI, 4.0–6.5), respectively (log-rank P = 0.04). There was no difference in overall survival between the two groups (log-rank P = 0.38). In the anlotinib group, treatment-related adverse events were reported in 15 patients (44.1%), with acute or late grade 3–5 adverse events identified in 14.7% of patients (n = 5).ConclusionsWBRT plus anlotinib, as a convenient chemo-free regimen, may represent an overall safe and effective procedure in advanced NSCLC with multiple BMs that progressed or developed after standard systematic treatment.

【 授权许可】

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Copyright © 2023 Kong, Yu, Qian, Song, Wen, Jiang, Zhu, Xu, Zhao, Guo, Wu, He and Zhu