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      The Efficacy and Safety of Anlotinib Combined With PD-1 Antibody for Third-Line or Further-Line Treatment of Patients With Advanced Non-Small-Cell Lung Cancer

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          Abstract

          Background

          Both anlotinib and programmed death 1 (PD-1) monoclonal antibody (mAb) have been approved for the third line treatment of metastatic non-small cell lung cancer (NSCLC). However, the combination of these two standard therapies has not been investigated in third-line or further-line treatment of patients with advanced NSCLC.

          Methods

          We reviewed 22 patients with NSCLC who received anlotinib combined with PD-1 mAb therapy from July 2018 to October 2019 at Sir Run Run Shaw Hospital. Based on the baseline characteristics, PD-L1 expression and EGFR mutation status, we retrospectively analyzed the efficacy and safety of this combination therapy by RESIST 1.1 and CTCAE 5.0.

          Results

          The combination treatment of anlotinib and PD-1 mAb in 22 NSCLC patients gained a median PFS of 6.8 months and a median OS of 17.3 months. The disease control rate (DCR) was 90.9%, and the objective response rate (ORR) was 36.4%, where 1 (4.6%) patient achieved complete response (CR) and 7 (31.8%) patients achieved partial response (PR). The median time to response was 3.9 months, and the median duration of the response was 6.8 months. The common grades 1–2 adverse events were fatigue 10/22 (45.5%), decreased appetite 9/22 (40.9%), hypertension 10/22 (45.5%); the common grades 3–4 adverse events were hypertension 2/22 (9.1%) and mouth ulceration 2/22 (9.1%).

          Conclusion

          Anlotinib combined with PD-1 mAb showed promising efficacy in third-line or further-line treatment of NSCLC, and its adverse effects is tolerable.

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          Most cited references37

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          Pembrolizumab versus Chemotherapy for PD-L1–Positive Non–Small-Cell Lung Cancer

          Pembrolizumab is a humanized monoclonal antibody against programmed death 1 (PD-1) that has antitumor activity in advanced non-small-cell lung cancer (NSCLC), with increased activity in tumors that express programmed death ligand 1 (PD-L1).
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            Nivolumab versus Docetaxel in Advanced Nonsquamous Non–Small-Cell Lung Cancer

            Nivolumab, a fully human IgG4 programmed death 1 (PD-1) immune-checkpoint-inhibitor antibody, disrupts PD-1-mediated signaling and may restore antitumor immunity.
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              • Record: found
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              The biology and management of non-small cell lung cancer.

              Important advancements in the treatment of non-small cell lung cancer (NSCLC) have been achieved over the past two decades, increasing our understanding of the disease biology and mechanisms of tumour progression, and advancing early detection and multimodal care. The use of small molecule tyrosine kinase inhibitors and immunotherapy has led to unprecedented survival benefits in selected patients. However, the overall cure and survival rates for NSCLC remain low, particularly in metastatic disease. Therefore, continued research into new drugs and combination therapies is required to expand the clinical benefit to a broader patient population and to improve outcomes in NSCLC.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                17 February 2021
                2020
                : 10
                : 619010
                Affiliations
                [1]Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University , Hangzhou, China
                Author notes

                Edited by: Ticiana A. Leal, University of Wisconsin-Madison, United States

                Reviewed by: Jinbo Yue, Shandong University, China; Wan Xiangbo, Six Affiliated Hospital of Sun Yat-sen University, China; Huilan Zhang, Huazhong University of Science and Technology, China

                *Correspondence: Weidong Han, hanwd@ 123456zju.edu.cn ; Hongming Pan, panhongming@ 123456zju.edu.cn ; Qin Pan, tianpanqin@ 123456yeah.net

                This article was submitted to Thoracic Oncology, a section of the journal Frontiers in Oncology

                †These authors have contributed equally to this work

                Article
                10.3389/fonc.2020.619010
                7927598
                33680942
                d8e34008-78b6-46e8-8cf6-477511baae9e
                Copyright © 2021 Zhai, Zhang, Ren, You, Pan, Pan and Han

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 19 October 2020
                : 30 December 2020
                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 37, Pages: 8, Words: 3885
                Categories
                Oncology
                Original Research

                Oncology & Radiotherapy
                nsclc,anlotinib hydrochloride,third line of therapy,tp53,egfr
                Oncology & Radiotherapy
                nsclc, anlotinib hydrochloride, third line of therapy, tp53, egfr

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