Maintenance Therapy with Apatinib in Extensive Disease Small Cell Lung Cancer

In a phase II trial, published in Thoracic Cancer, researchers evaluated the impact of apatinib as a maintenance treatment in patients with extensive-disease small cell lung cancer (ED-SCLC) after they had undergone standard first-line chemotherapy. According to primary investigator, Fei Teng, “apatinib maintenance therapy showed promising efficacy and safety to extend the OS/PFS of patients with ED-SCLC, thus making it a potent therapeutic option in future clinical practice.”

The trial’s participants received apatinib 250 mg per day during their chemotherapy regimen and then as a maintenance therapy after four to six cycles—until patients experienced disease progression, death, or unmanageable drug-related toxicity. The primary endpoints of the study were overall survival (OS) and progression-free survival (PFS), while secondary measures included safety and toxicity.

The authors reported that patients achieved a median PFS of 3.7 months (95% confidence interval [CI], 1.3–6.2) and a median OS of 16.3 months (95% CI, 9.7–22.8). The rate of objective response was 50% and the rate of disease control was 66.7%. Regarding toxicity, two patients required a dosage reduction due to adverse effects (AEs), and the most common AEs included hypertension (n = 4; 33.3%) and hand-foot-skin reaction (n = 2; 16.7); the most serious AE reported was intestinal obstruction; and other AEs included diarrhea and hemoptysis in one patient each.

Overall, Teng and the investigators judged that apatinib had “promising” results as a maintenance therapy after first-line chemotherapy in patients with ED-SCLC, with the potential to improve survival outcomes. However, they acknowledged that, “given the small sample size of this study, further studies with large sample sizes are needed to validate the findings of the present study.”