Metastatic disease to the lung is one of the most common life-threatening complications of cancer and can be seen with most types of cancer. Apatinib, a tyrosine kinase inhibitor targeting VEGFR-2, has shown efficacy in lung cancer. And the preclinical data also showed plasma concentration of apatinib was high in the lung. This cancer registry study aims to make an exploratory assessment of the efficacy and safety of apabinib in lung metastases.
Between 2015/05 and 2018/03, this study recorded all patients with advanced cancers in our hospital, with apatinib 500 mg or 250 mg being given. Tumor response assessment and survival analysis were performed.
For a total of 103 patients, 30 had no lung metastases, and 73 had lung metastases, among which most were bone sarcoma (56%) and soft-tissue sarcoma (37%) metastases to lung. Among 57 evaluable patients with lung metastases, 2 achieved CR, 29 achieved PR, and the ORR was 54%. In 11 evaluable patients with no lung metastases, no patient achieved CR, 3 patients achieved PR, and the ORR was 27%. For patients with lung metastases, the mPFS was 12.9 months (95%CI, 8.6-14.9 months), mOS was 21.9 months (95% CI, 15.9-31.3 months). For patients with no lung metastases, the mPFS was 6.0 months (95%CI, 4.6-NE months), the mOS was 10.7 months (95% CI, 5.2-NE months). In lung metastatic patients who received apatinib 500mg, the ORR and DCR were, respectively, 55.1% and 89.8%; when treated with apatinib 250mg, the ORR and DCR were 20% and 80%. When Apatinib was used as first line treatment, the ORR and DCR were respectively 64% and 88%; in second line treatment, the ORR and DCR were respectively 42% and 84%, and when apatinib was used in third line treatment, the ORR and DCR were 33% and 100%. For patients with lung metastases, 89.2% patients experienced adverse events (AEs); the most frequent AEs were hand-foot syndrome (21.6%), diarrhea (20%), hypertension (24.3%) and albuminuria (9.4%).
Based on this exploratory analysis, for bone sarcoma and soft-tissue sarcoma with lung metastases, apatinib 500mg showed promising trends in efficacy and safety profile. An expansion study will be needed.
Clinical trial identification
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Has not received any funding.
All authors have declared no conflicts of interest.