PMID- 36090635
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220913
IS  - 2218-6751 (Print)
IS  - 2226-4477 (Electronic)
IS  - 2218-6751 (Linking)
VI  - 11
IP  - 8
DP  - 2022 Aug
TI  - Efficacy and safety of anlotinib combined with carboplatin and pemetrexed as 
      first-line induction therapy followed by anlotinib plus pemetrexed as maintenance 
      therapy in EGFR/ALK wild-type advanced non-squamous non-small cell lung cancer in 
      China: a multicenter, single-arm trial.
PG  - 1657-1666
LID - 10.21037/tlcr-22-558 [doi]
AB  - BACKGROUND: The efficacy and safety of chemotherapy strategies combining the 
      multi-target receptor tyrosine kinase inhibitor in patients with advanced 
      EGFR/ALK wild-type non-squamous non-small-cell lung cancer (nsq-NSCLC) are 
      undetermined. We aimed to investigate the efficacy and safety of anlotinib 
      combined with carboplatin/pemetrexed-based chemotherapy followed by maintenance 
      therapy (anlotinib plus pemetrexed) in advanced EGFR/ALK wild-type nsq-NSCLC. 
      METHODS: Eligible patients with wild-type EGFR/ALK advanced nsq-NSCLC who 
      received first-line therapy in Henan Province from March 2019 to February 2021 
      were recruited. All patients were treated with anlotinib in combination with 
      carboplatin/pemetrexed-based chemotherapy, followed by maintenance therapy 
      (anlotinib plus pemetrexed). The primary endpoint was progression-free survival 
      (PFS). The secondary endpoints included overall survival (OS), disease control 
      rate (DCR), objective response rate (ORR), and adverse events (AEs). Response and 
      AEs were assessed based on the Response Evaluation Criteria in Solid Tumors (1.1) 
      and National Cancer Institute - Common Terminology Criteria for Adverse Events 
      v.4.0.3, respectively. The follow-up interval for survival was 6 weeks and the 
      safety follow-up was performed until the end of treatment. Kaplan-Meier analysis 
      was used to calculate the median PFS and OS. RESULTS: Thirty-eight participants 
      with median age of 62 (range, 33-75) years were evaluated. Five participants were 
      still on maintenance therapy until the end of the study. The majority were 
      non-smokers (68.4%). The median follow-up was 13.6 (range, 12.3-14.9) months. The 
      median PFS (mPFS) was 10.5 (95% CI: 4.1, 17.0) months, and the median OS was 23.4 
      [95% CI: not evaluable (NE), NE] months. The DCR and ORR were 94.7% and 60.5%, 
      respectively. Grade 3 and above treatment-related adverse events (TRAEs) happened 
      to 12 participants. The most common TRAEs were hypertension (23.7%), neutropenia 
      (19.4%), and bone marrow toxicity (10.5%). Seven patients discontinued treatment, 
      including two patients during induction and five patients during maintenance 
      treatment. No grade 5 TRAE was reported. In the non-smoker participants, the mPFS 
      was 14.5 (95% CI: 4.0-25.0) months. CONCLUSIONS: Anlotinib in combination with 
      carboplatin/pemetrexed-based chemotherapy followed by anlotinib plus pemetrexed 
      as maintenance therapy might be an effective choice in treating patients with 
      wild-type EGFR/ALK advanced nsq-NSCLC.
CI  - 2022 Translational Lung Cancer Research. All rights reserved.
FAU - He, Zhen
AU  - He Z
AD  - Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer 
      Hospital of Zhengzhou University, Zhengzhou, China.
FAU - Yang, Xiuli
AU  - Yang X
AD  - Department of Oncology, The First Affiliated Hospital of Nanyang Medical College, 
      Nanyang, China.
FAU - Ma, Tianjiang
AU  - Ma T
AD  - Department of Medical Oncology, Luohe Central Hospital, Luohe, China.
FAU - Yang, Qiumin
AU  - Yang Q
AD  - Department of Oncology, Shangqiu First People's Hospital, Shangqiu, China.
FAU - Zhang, Chenghui
AU  - Zhang C
AD  - Department of Oncology, Nanyang Central Hospital, Nanyang, China.
FAU - Chen, Yunfang
AU  - Chen Y
AD  - Department of Oncology, Zhumadian Central Hospital, Zhumadian, China.
FAU - Wang, Pengyuan
AU  - Wang P
AD  - Department of Medical Oncology, Xuchang Central Hospital, Xuchang, China.
FAU - D'Incecco, Armida
AU  - D'Incecco A
AD  - Medical Oncology Unit, "G. Mazzini" Hospital of Teramo, Teramo, Italy.
FAU - Metro, Giulio
AU  - Metro G
AD  - Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di 
      Perugia, Perugia, Italy.
FAU - Uematsu, Shugo
AU  - Uematsu S
AD  - Respiratory Disease Center, Showa University Northern Yokohama Hospital, 
      Kanagawa, Japan.
FAU - Wang, Qiming
AU  - Wang Q
AD  - Department of Internal Medicine, Henan Cancer Hospital, Affiliated Cancer 
      Hospital of Zhengzhou University, Zhengzhou, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Transl Lung Cancer Res
JT  - Translational lung cancer research
JID - 101646875
PMC - PMC9459624
OTO - NOTNLM
OT  - Anlotinib
OT  - carboplatin
OT  - non-small-cell lung cancer (NSCLC)
OT  - non-squamous
OT  - pemetrexed
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://tlcr.amegroups.com/article/view/10.21037/tlcr-22-558/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2022/09/13 06:00
MHDA- 2022/09/13 06:01
PMCR- 2022/08/01
CRDT- 2022/09/12 03:46
PHST- 2022/05/20 00:00 [received]
PHST- 2022/08/15 00:00 [accepted]
PHST- 2022/09/12 03:46 [entrez]
PHST- 2022/09/13 06:00 [pubmed]
PHST- 2022/09/13 06:01 [medline]
PHST- 2022/08/01 00:00 [pmc-release]
AID - tlcr-11-08-1657 [pii]
AID - 10.21037/tlcr-22-558 [doi]
PST - ppublish
SO  - Transl Lung Cancer Res. 2022 Aug;11(8):1657-1666. doi: 10.21037/tlcr-22-558.