Observation Of The Efficacy Of Apatinib In The Treatment Of Extensive-Stage Small Cell Lung Cancer That Failed First-Line Or Multiple Lines Of Therapy

Objective: Patients with extensive-stage small cell lung cancer(SCLC)often quickly relapse and metastasize after first-line chemotherapy,and there is a lack of effective therapies after the development of chemotherapy resistance.In this study,we studied the efficacy and safety of apatinib in the treatment of extensive-stage SCLC that failed first-line or multiple lines of therapy and analyzed the factors affecting the prognosis in order to find new treatment options for SCLC that has failed first-line or multiple lines of therapy.Methods: Data were collected from 31 patients with extensive-stage SCLC who visited the affiliated Yijishan Hospital of Wannan Medical College from July 2018 to October2019.Only patients who have failed first-line or multiple lines of therapy were selected.Apatinib(500 mg)was taken orally once daily and the dosage was reduced to 250 mg once daily for patients who developed severe adverse reactions.The drug administration was discontinued if the adverse reactions could not be tolerated at the 250 mg dosage.Radiology data and blood tests as well as adverse reactions of all patients were recorded,and the disease progress of each patient was closely observed until Apatinib treatment was stopped.The efficacy of Apatinib was evaluated according to the efficacy evaluation criteria for solid tumors(RECIST 1.1).SPSS20.0 was used to construct the survival curve and analyze the factors affecting the prognosis.Results: Among all 31 SCLC patients treated with Apatinib,no patients achieved complete remission(CR)(0%),5 patients had partial remission(PR)(16.1%),19 patients had stable disease(SD)(61.2%),and 8 patients had progressive disease(PD)(25.8%).The objective response rate(ORR)was 16.1% and the disease control rate(DCR)was 77.3%.The median Progression Free Survival(FPS)was 3.2 months.Major adverse reactions included hypertension(48.4%),hand-foot syndrome(45.2%),proteinuria(22.5%),fatigue(29.0%),and myelosuppression(22.5%),most of which were either grade 1 or grade 2 adverse reactions.Age,gender,smoking history and previous treatment history had no effect on patients’ PFS while ECOG score and degree of adverse reactions were independent factors affecting the prognosis.Conclusion: Apatinib treatment can achieve outstanding ORR and DCR in SCLC patients who have failed first-line or multiple lines of chemotherapy and can significantly prolong patients’ PFS with controllable safety.Apatinib treatment has a better prognosis in SCLC patients associated with low ECOG score and produces some mild adverse reactions.