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Pu X, Xiao Z, Li J, Wu Z, Ma Z, Weng J, Xiao M, Chen Y, Cao Y, Cao P, Wang Q, Xu Y, Li K, Chen B, Xu F, Liu L, Kong Y, Zhang H, Duan H, Wu L. Anlotinib plus docetaxel vs. docetaxel alone for advanced non-small-cell lung cancer patients who failed first-line treatment: A multicenter, randomized phase II trial. Lung Cancer 2024; 191:107538. [PMID: 38552544 DOI: 10.1016/j.lungcan.2024.107538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/15/2024] [Accepted: 03/16/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVES Given the modest efficacy of docetaxel in advanced non-small cell lung cancer (NSCLC), this study assesses the therapeutic potential and safety profile of anlotinib in combination with docetaxel compared to docetaxel monotherapy as a second-line therapy for patients with advanced NSCLC. MATERIALS AND METHODS In this phase II study, patients with advanced NSCLC experiencing failure with first-line platinum-based regimens were randomized in a 1:1 ratio to receive either anlotinib plus docetaxel or docetaxel alone. Primary endpoint was progression-free survival (PFS), with overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety as secondary endpoints. RESULTS A total of 83 patients were randomized. The combination of anlotinib and docetaxel significantly extended median PFS to 4.4 months compared to 1.6 months for docetaxel alone (hazard ratio [HR] = 0.38, 95 % confidence interval [CI]: 0.23-0.63, P = 0.0002), and also demonstrated superior ORR (32.5 % vs. 9.3 %, P = 0.0089) and DCR (87.5 % vs. 53.5 %, P = 0.0007). Median OS was observed at 12.0 months in the combination group vs. 10.9 months in the monotherapy group (HR = 0.82, 95 % CI: 0.47-1.43, P = 0.4803). For patients previously treated with immunotherapy, the median PFS was notably longer at 7.8 vs. 1.7 months (HR = 0.22, 95 % CI: 0.09-0.51, P = 0.0290). The incidence of grade ≥ 3 treatment-related adverse events, predominantly leukopenia (15.0 % vs. 7.0 %) and neutropenia (10.0 % vs. 5.0 %), was manageable across both groups. CONCLUSION Anlotinib plus docetaxel offers a viable therapeutic alternative for patients with advanced NSCLC who failed first-line platinum-based treatments.
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Affiliation(s)
- Xingxiang Pu
- Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Zemin Xiao
- Department of Oncology, The First People's Hospital of Changde City, Changde, China
| | - Jia Li
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Zhijun Wu
- Department of Oncology, The First People's Hospital of Changde City, Changde, China
| | - Zhongxia Ma
- Department of Thoracic Oncology Surgery, The First People's Hospital of Chenzhou City, Chenzhou, China
| | - Jie Weng
- Department of Oncology, Yueyang Central Hospital, Yueyang, China
| | - Maoliang Xiao
- Department of Oncology, Hunan Province Directly Affiliated Traditional Chinese Medicine Hospital, Zhuzhou, China
| | - Yanhua Chen
- Department of Hematology and Oncology, The Second Affiliated Hospital of University of South China, Hengyang, China
| | - Yongqing Cao
- Department of Hematology and Oncology, The First Hospital of Changsha, Changsha, China
| | - Peiguo Cao
- Department of Oncology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Qianzhi Wang
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yan Xu
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Kang Li
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Bolin Chen
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Fang Xu
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Liyu Liu
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yi Kong
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Hui Zhang
- Department of Oncology, The Central Hospital of Shaoyang, Shaoyang, China
| | - Huaxin Duan
- Department of Oncology, People's Hospital of Hunan Province, Changsha, China
| | - Lin Wu
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
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Kozuki T, Nogami N, Hataji O, Tsunezuka Y, Seki N, Harada T, Fujimoto N, Bessho A, Takamura K, Takahashi K, Satouchi M, Kato T, Shukuya T, Yamashita N, Okamoto H, Shinkai T. Open-label, multicenter, randomized phase II study on docetaxel plus bevacizumab or pemetrexed plus bevacizumab for treatment of elderly (aged ≥75 years) patients with previously untreated advanced non-squamous non-small cell lung cancer: TORG1323. Transl Lung Cancer Res 2020; 9:459-470. [PMID: 32676310 PMCID: PMC7354128 DOI: 10.21037/tlcr.2020.03.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Background The effectiveness of bevacizumab monotherapy in elderly patients with non-squamous non-small cell lung cancer (NSCLC) is unclear. The efficacy of the combinations for elderly patients was explored. Methods Untreated patients (≥75 years; performance status 0–1) with stage IIIB, IV, or recurrent non-squamous NSCLC were included. Patients with epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) gene rearrangements were eligible even if they received tyrosine kinase inhibitors. Patients were randomized 1:1 to receive docetaxel (50 mg/m2) (DB) or pemetrexed (500 mg/m2) (PB) with bevacizumab (15 m/kg). The primary endpoint was progression-free survival (PFS). Treatment was administered every 3 weeks until disease progression or unacceptable toxicity. Results Overall, 103 patients (DB: n=51; PB: n=52) were enrolled. In the DB and PB arms, median ages [range] were 78 [75–88] and 79 [75–94] years, respectively; median PFS were 6.1 and 4.6 months, respectively [hazard ratio (HR), 1.03; 95% confidence interval (CI), 0.66–1.61]; and response rates were 43%, and 40%, respectively (P=0.840). Grade ≥3 leukopenia, neutropenia, and fatigue incidences were significantly higher in the DB arm. Febrile neutropenia incidence did not differ significantly (16% vs. 12%, P=0.578). One patient in the PB arm died from a ruptured abdominal aortic aneurysm. Quality of life (QoL) analysis revealed less deterioration in the PB arm. Conclusions In previously untreated elderly patients with non-squamous NSCLC, PB shows feasibility, better QoL, and promising efficacy in terms of PFS, and an objective response rate for further analysis (UMIN000012786).
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Affiliation(s)
- Toshiyuki Kozuki
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Naoyuki Nogami
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Osamu Hataji
- Department of Respiratory Medicine, Matsusaka Municipal Hospital, Matsusaka, Mie, Japan
| | - Yoshio Tsunezuka
- Department of General Thoracic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan
| | - Nobuhiko Seki
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Toshiyuki Harada
- Department of Respiratory Medicine, Japan Community Health Care Organization Hokkaido Hospital, Toyohira-ku, Sapporo, Japan
| | - Nobukazu Fujimoto
- Department of Respiratory Medicine, Okayama Rosai Hospital, Minami-ku, Okayama-shi, Okayama, Japan
| | - Akihiro Bessho
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Kita-ku, Okayama-shi, Okayama, Japan
| | - Kei Takamura
- Department of Respiratory Medicine, Obihiro Kosei General Hospital, Obihiro-shi, Hokkaido, Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine, Juntendo University Hospital, Bunkyo-ku, Tokyo, Japan
| | - Miyako Satouchi
- Department of Thoracic Oncology, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Terufumi Kato
- Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Takehito Shukuya
- Department of Respiratory Medicine, Juntendo University Hospital, Bunkyo-ku, Tokyo, Japan
| | - Natsumi Yamashita
- Clinical Research Center, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan
| | - Tetsu Shinkai
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan.,Department of Respiratory Medicine, Shonan Eastern General Hospital, Chigasaki, Kanagawa, Japan
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Shimizu T, Nakagawa Y, Asai Y, Tsujino I, Takahashi N, Gon Y. A phase II study of the combination of docetaxel and bevacizumab for previously treated non-small cell lung cancer. J Int Med Res 2019; 47:3079-3087. [PMID: 31179803 PMCID: PMC6683925 DOI: 10.1177/0300060519852202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective The standard therapies for previously treated advanced non-small cell lung cancer (NSCLC) include docetaxel (DOC). Bevacizumab (BV), an antivascular endothelial growth factor (VEGF) antibody, increases the antitumor effect of cytotoxic anticancer agents. A BV-containing combination regimen is recommended as the primary therapy for advanced non-squamous NSCLC. However, the efficacy of DOC + BV is unknown in patients with previously treated advanced NSCLC. We conducted a phase II clinical study of DOC + BV for patients with previously treated advanced non-squamous NSCLC. Methods Twenty-three patients were enrolled in this study from June 2011 through May 2014. Chemotherapy was repeated every 21 days unless there was evidence of disease progression or intolerance to the study treatment. We assessed efficacy and toxicity. Results The median progression-free survival was 30.7 weeks. The response rate was 47.8%. The most common grade ≥3 adverse events were neutropenia (20 patients, 87.0%) and febrile neutropenia (7 patients, 30.4%). Conclusions The combination of DOC and BV often resulted in serious neutropenia, suggesting that this regimen is difficult to tolerate.
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Affiliation(s)
- Tetsuo Shimizu
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshiko Nakagawa
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuo Asai
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Ichirou Tsujino
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Noriaki Takahashi
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yasuhiro Gon
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
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Osimertinib compared docetaxel-bevacizumab as third-line treatment in EGFR T790M mutated non-small-cell lung cancer. Lung Cancer 2018; 121:5-11. [DOI: 10.1016/j.lungcan.2018.04.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/25/2018] [Accepted: 04/12/2018] [Indexed: 12/11/2022]
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Wang L, Li Y, Zhang X, Li H. Characteristics of nosocomial infection and its effects on the survival of chemotherapy patients with advanced non-small cell lung cancer. Oncol Lett 2017; 14:7379-7383. [PMID: 29344177 PMCID: PMC5755245 DOI: 10.3892/ol.2017.7144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/27/2017] [Indexed: 12/17/2022] Open
Abstract
The present study was planned to investigate the characteristics of nosocomial infection and its effects on the survival in advanced non-small cell lung cancer (NSCLC) patients. Retrospective analysis was performed for the 169 chemotherapy patients with NSCLC and nosocomial infection during hospitalization in Binzhou City Central Hospital from March, 2013 to January, 2015. In addition, 170 patients without nosocomial infection were also involved as a control group. The distribution of major drug resistance of Gram-negative (G−) and Gram-positive (G+) were analyzed. The survival conditions of the patients were analyzed according to the nosocomial infection occurrence. The risk factors of nosocomial infection in patients with NSCLC were analyzed by univariate and multivariate logistic analysis. The percentage of G+ infection was 45.6% while G− infection was 54.4%. Nosocomial infections were most common in respiratory system. The median survival time of the observation group was shorter than that of the control group (P<0.05). G− infection was the most common type of infection in nosocomial infection of the patients with NSCLC. The occurrence of infection seriously affected the survival time of patients. Attention is required to the patients older than 60 years undergoing treatment with glucocorticoids as well as immunosuppressive agents.
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Affiliation(s)
- Lili Wang
- Department III of Oncology, Binzhou City Central Hospital, Binzhou, Shandong 251700, P.R. China
| | - Yan Li
- Department of Hospital Infection-Control, Binzhou City Central Hospital, Binzhou, Shandong 251700, P.R. China
| | - Xia Zhang
- Department of Obstetrics, Binzhou City Central Hospital, Binzhou, Shandong 251700, P.R. China
| | - Hongxia Li
- Department of Senior Cadres, Binzhou City Central Hospital, Binzhou, Shandong 251700, P.R. China
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