388P - Anlotinib or bevacizumab combined with chemotherapy for the second-line HER-2 negative metastatic breast cancer: A retrospective cohort study

Background

Antiangiogenic drugs have demonstrated synergistic effect with chemotherapy in advanced triple negative breast cancer. Anlotinib is an oral multi-target tyrosine kinase inhibitor (TKI) that strongly inhibits VEGFR, PDGFR, FGFR, and c-kit. There have been no studies of compared differences in the efficacy of anlotinib and bevacizumab in MBC patients. This study was designed to evaluate the efficacy of anlotinib or bevacizumab when combined with chemotherapy for the second-line or subsequent treatment of HER-2-MBC.

Methods

As of April 2024, 106 patients were retrospectively reviewed. These included 50 and 56 patients in the anlotinib and bevacizumab plus chemotherapy groups, respectively. Anlotinib (12 mg qd. d1-14 q3w) was orally administered. Bevacizumab (10 mg/kg, q3w) was intravenously administered. Chemotherapy regimens consisted of capecitabine, docetaxel, nab-paclitaxel, or paclitaxel, with respective doses of 1,000 mg/m2 tiw d1-14 q3w, 75-100 mg/m2 iv. q3w, 260 mg/m2 iv. q3w, and 175 mg/m2 iv. q3w. The primary endpoint is PFS and secondary endpoints are ORR, DCR, and OS.

Results

The median follow-up intervals as of the cut-off deadline were 24.3 and 26.5 months in the anlotinib and bevacizumab groups, respectively. Of these patients, 58% exhibited HR-positive disease. There were no differences in patient age (P=0.07), ECOG status (P=0.43), or prior systematic treatment (P=0.16) when comparing two groups. In the anlotinib and bevacizumab groups, the respective ORRs were 42% and 33.9% (P > 0.05), while the DCRs were 86% and 69.6%. Patients in the anlotinib group exhibited significantly longer mPFS and mOS as compared to the bevacizumab group (PFS: 6.0 vs. 5.3 months, HR 0.636 [95% CI 0.412-0.981], P = 0.033; OS: 17.1 vs. 15.0 months, HR 0.581 [95% CI 0.3741-0.9017], P = 0.015). Subgroup analyses additionally revealed that patients who underwent a combination of anlotinib and taxane treatment achieved the longest PFS (7.0 months) and OS (18.3 months). The most frequently detected treatment-related adverse events were grade 1/2 events.

Conclusions

Anlotinib plus chemotherapy have shown favorable efficacy and acceptable safety profile in patients with advanced HER-2-negative MBC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.