| Background Gynecological cancer(GC)is the most common type of cervical cancer(CC),endometrial cancer(EC)and ovarian cancer(OC).At present,the effective rate of salvage chemotherapy for patients with advanced refractory and refractory gynecological tumors is very low,and there is a lack of subsequent treatment options after the failure of standard treatment for gynecological tumors.Anti-angiogenesis drugs combined with chemotherapy and immunotherapy as second-line treatment can prolong the survival time of patients with gynecological tumors.Therefore,antiangiogenesis drugs have important clinical significance in the treatment of gynecological tumors.Finding predictors of the efficacy of antiangiogenic drugs in order to screen the advantageous population and achieve precision treatment is a research hotspot.At present,there are few studies on anti-angiogenic drugs and their efficacy predictors in the field of gynecological oncology.Objective The aim of this study is to explore the efficacy and safety of anlotinib in the treatment of advanced recurrent and refractory gynecological tumors and screen out biomarkers with predictive value for efficacy,in order to guide the selection of clinical individualized treatment regimens,obtain better clinical efficacy,and evaluate its efficacy and safety to provide basis and reference for the clinical application of antiangiogenesis therapy in gynecological tumors beyond the second-line.Methods The clinical data of 38 patients diagnosed with advanced recurrent and refractory gynecological tumors in the Affiliated Hospital of Guangzhou Medical University from September 2018 to June 2022 were retrospectively analyzed.The enrolled patients were treated with oral anlotinib hydrochloride capsules(Fu Ke Wei,manufacturer: Chia Tai Tianqing Pharmaceutical Group Co.,LTD.,H20180004,specification: 12 mg× 7capsules),the initial dose was 12 mg/ time,1 time /d,continuous treatment for 2 weeks,drug withdrawal for 1 week,every 3 weeks as a treatment cycle,that is 21 days.If the patient’s adverse reactions reached grade 3 or above,the dose would be reduced to 10mg/d or 8 mg/d.The efficacy was evaluated after 2 courses of continuous treatment,and the clinical efficacy,progression-free survival(PFS)and adverse reactions were observed and analyzed.Treatment was continued until disease progression,death,or intolerable adverse effects.Results The objective response rate(ORR)and disease control rate(DCR)of 19 patients with ovarian cancer were 73.68% and 100.00%,respectively.The ORR and DCR of 14 cases of cervical cancer were 85.71% and 100.00%,respectively.The ORR and DCR of 5 cases of endometrial cancer were 60.00% and 80.00%,respectively.In addition,19 patients with ovarian cancer had a median PFS of 10.6 months and an average OS of 22.6 months,14 patients with cervical cancer had a median PFS of 9.2 months and an average OS of 24.8 months,and 5 patients with endometrial cancer had a median PFS of 10.4 months and an average OS of 10.6 months.The incidence of grade 1-3adverse reactions was 74.7%,and the incidence of grade 4 or above adverse reactions was 26.3%,which was well tolerated.Conclusion Anlotinib has a good short-term efficacy in the treatment of advanced recurrent and refractory gynecological tumors,which can effectively delay the development of the disease,prolong the survival of patients,and has tolerable safety. |
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