Successful treatment using apatinib with or without docetaxel in heavily pretreated advanced non-squamous non-small cell lung cancer: A case report and literature review
Successful treatment using apatinib with or without docetaxel in heavily pretreated advanced non-squamous non-small cell lung cancer: A case report and literature review
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DOI：
10.1080/15384047.2017.1414757
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发表时间：
2018-01-01
影响因子：
3.6
通讯作者：
Zhou, Caicun
中科院分区：
文献类型：
--
作者：
Wu, Fengying;Zhan, Shijia;Zhou, Caicun
尽管针对驱动突变的靶向治疗对非小细胞肺癌（NSCLC）患者产生了显著的疗效获益，但许多患者并不具有与获批靶向药物相关的突变。血管生成药物在晚期NSCLC的治疗策略中起着重要作用。阿帕替尼是一种靶向血管内皮生长因子受体2的新型酪氨酸激酶抑制剂。一项II期临床试验证明了阿帕替尼单药治疗晚期NSCLC的生存获益。此外，无论肿瘤组织学如何，在化疗中添加抗血管生成剂在晚期NSCLC中显示出稳健的疗效。在此，我们报告了一例接受过大量预治疗的肺腺癌患者，该患者接受阿帕替尼和阿帕替尼持续治疗加多西他赛再激发治疗。他对几种驱动基因呈阴性，包括EGFR、ALK、KRAS、ROS 1、HER2、RET和BRAF。既往治疗包括含铂双联治疗、培美曲塞单药治疗、多西他赛+贝伐珠单抗、吉非替尼单药治疗、白蛋白结合型紫杉醇单药治疗、伊立替康+奥沙利铂和放疗。他在阿帕替尼单药治疗和阿帕替尼加多西他赛治疗后均获得部分缓解，无进展生存期分别为5个月和6个月。该病例表明，阿帕替尼单药治疗或阿帕替尼加多西他赛可作为既往接受过大量治疗的晚期非鳞状NSCLC患者的治疗选择。
Although targeted therapy directed toward driver mutations has produced a significant efficacy benefit for patients with non-small cell lung cancer (NSCLC), many patients do not possess mutations associated with the approved targeted drugs. Angiogenic agents play an important role in the therapeutic strategy for advanced NSCLC. Apatinib is a novel tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor-2. A phase II clinical trial demonstrated the survival benefit of apatinib monotherapy in advanced NSCLC. Moreover, addition of anti-angiogenic agents to chemotherapy showed robust efficacy in advanced NSCLC, regardless of tumor histology. Here, we present the case of a heavily pretreated lung adenocarcinoma patient who was treated with apatinib and apatinib continuation plus docetaxel re-challenge. He was negative for several driver genes, including EGFR, ALK, KRAS, ROS1, HER2, RET and BRAF. The previous treatment included platinum-based doublets, pemetrexed monotherapy, docetaxel plus bevacizumab, gefitinib monotherapy, nab-paclitaxel monotherapy, irinotecan plus oxaliplatin and radiotherapy. He obtained a partial response after both apatinib monotherapy and apatinib plus docetaxel treatment, with progression-free survival durations of 5 months and 6 months, respectively. This case indicated that apatinib monotherapy or apatinib plus docetaxel might be regarded as a therapeutic option for heavily pretreated patients with advanced non-squamous NSCLC.