Abstract 50P
Background
Bevacizumab resistance is inevitable with limited treatment options and clinical benefit. Anlotinib is a novel multitarget tyrosine kinase inhibitors for tumor angiogenesis and proliferative signaling. Recent studies have suggested that anlotinib can reverse resistance to bevacizumab by downregulating RGC32 or inhibiting TGFβ1 pathways. We conducted a real-world data analysis to investigate the efficacy and safety of anlotinib for solid tumors in Chinese patients treated with bevacizumab previously. Here we report the outcomes of patients with non-squamous NSCLC.
Methods
We retrospectively collected the clinical data of 746 patients with non-squamous NSCLC from six medical sites in China between Jan 2018 and May 2024. Propensity score matching (PSM) based on age, gender, and lines of therapy was used. Progression-free survival (PFS) was estimated using the Kaplan-Meier method and compared using the log-rank test.
Results
First, to evaluate the impact of previous bevacizumab on the efficiency of anlotinib, we divided the patients with anlotinib monotherapy into two groups: the bevacizumab-treated group (n=108) and the bevacizumab-free group (n=174). After PSM, there were 73 and 146 patients in the bevacizumab-treated and the bevacizumab-free group, respectively, with similar PFS (median, 6.4 vs 7.5 months; HR 1.20, 95% CI 0.83–1.73; P=0.334). We further divided the bevacizumab-treated patients into three groups according to the subsequent treatments: the anlotinib monotherapy group (n=108), the anlotinib combination group (n=345), and the other treatment without anti-angiogenic TKIs group (n=119). After PSM, the PFS was similar between the anlotinib monotherapy (n=93) and other treatment group (n=93) (median, 5.8 vs 5.2 months; HR 0.95, 95% CI 0.66–1.36; P=0.769), whereas the PFS was significantly longer in the anlotinib combination group (n=297) than in other treatment group (n=99) (median, 6.4 vs 5.2 months; HR 0.76, 95% CI 0.57–1.00; P=0.048).
Conclusions
Our study showed previous bevacizumab didn’t effect the efficiency of anlotinib in NSCLC. Anlotinib monotherapy can achieve comparable results to other treatments, and anlotinib combination may benefit bevacizumab-treated patients more.
Legal entity responsible for the study
Shanghai Pulmonary Hospital.
Funding
National Natural Science Foundation of China (82373319; 82172869).
Disclosure
All authors have declared no conflicts of interest.