Abstract 1631P
Background
Thymic epithelial tumors (TETs) are rare thoracic malignancies with no standard second-line treatment. Tumor angiogenesis is closely associated with the pathogenesis and invasiveness of TETs. Anlotinib is a small-molecule multi-target tyrosine kinase inhibitor (TKI) which inhibits tumor angiogenesis and tumor cell proliferation. Published studies have demonstrated the promising clinical effect of multi-target TKIs sunitinib and lenvatinib in previously treated TETs. However, TKIs have high incidence of adverse events (AEs). In this study, we investigated the clinical efficacy and safety of anlotinib in previously-treated TET patients.
Methods
We collected clinical data of 22 patients from Shandong cancer hospital and institute between October 2018 and March 2022. These patients were diagnosed with advanced TETs and have received at least the 1st line treatment. We analyzed clinical effect between anlotinib monotherapy and anlotinib combination therapy in the 2nd line or anlotinib treatment in different lines.
Results
These 22 patients included 18 cases of thymic carcinoma (TC) and 4 cases of thymoma (T). 68.2% patients were males, and median age was 53 years. Fourteen patients (63.6%) received anlotinib monotherapy and 8 patients (36.4%) received anlotinib combination therapy. In the overall population, ORR was 9.1% and DCR was 81.8%. The median PFS in overall population was 12 months (14 months for T and 9 months for TC), and the median OS was 24 months (survival was not reached for T and 24 months for TC). The median PFS was 9, 24.3 and 10 months for second line, third line and fourth line treatment, respectively. and the median OS was 23, 24.3 and 24 months for second line, third line and fourth line treatment, respectively. The incidence of AEs was 50%, most of them were grades I and II, and the incidence of grades III and IV AEs was 9%.
Conclusions
The survival data indicate that the efficacy of anlotinib is superior to sunitinib and lenvatinib. The AEs and toxicity were significantly lower than that of using sunitinib or lenvatinib. Our results suggest that anlotinib is a promising treatment option for previously-treated TET patients and its toxicity is tolerable.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University and Shandong Academy of Medical Science.
Funding
The National Natural SciencesFoundation of China (no.8150111724; to H.Zhang), the Joint Fund for Cancer Prevention and Treatment of Shan dong Natural Fund (no.ZR2019LZL015; to H.Zhang), the National Key Research and Development Projects of China (2018YFC1312201), the Radiation Oncology Innovate Unit, Chinese Academy of Medical Sciences (2019RU071), the Academic Promotion Program of Shandong First Medical University (2019ZL002), the foundation of National Natural Science Foundation of China (81972863, 81627901and 82030082), the CSCO-2019 Hausen Oncology Research Fund Project (Y-HS2019-52) and The Key Research and Development Program of Shandong Province (Grant No. 2018GSF118097).
Disclosure
All authors have declared no conflicts of interest.