Efficacy, safety and predictive indicators of apatinib after multilines treatment in advanced nonsquamous nonsmall cell lung cancer: Apatinib treatment in nonsquamous NSCLC.

Aim: Patients with advanced nonsquamous nonsmall cell lung cancer (NSCLC) who experienced progression with two or more lines chemotherapy have no treatment options that clearly confer a survival benefit. As a novel vascular endothelial growth factor receptor‐2 tyrosine kinase inhibitor, apatinib has a certain antitumor effect for various solid tumors. The present study evaluated the efficacy and safety of apatinib in advanced nonsquamous NSCLC as salvage treatment in Chinese real‐world practice. Methods: Twenty‐eight patients were enrolled in this observational study from October 2015 to May 2017. Progression‐free survival (PFS) and overall survival (OS) were graphed by Kaplan–Meier curve and intergroup comparisons were carried out by log‐rank test. Objective response rate (ORR), disease control rate (DCR) and adverse effects (AEs) were also evaluated. Results: Seven patients obtained partial response, and 18 obtained stable disease, representing an ORR of 26% and a DCR of 93%. Median PFS and OS were 3 (95% confidence interval [CI] 2.6–3.4) and 7.4 (95% CI 1.3–13.5) months, respectively. The efficacy analysis showed that Eastern Cooperative Oncology Group (ECOG) performance status 0–1 was correlated with prolonged OS and PFS (P < 0.05), and hypertension during apatinib treatment was correlated with prolonged OS (P < 0.05). Cox regression showed that ECOG performance status (P < 0.01) (RR = 0.231) (95% CI 0.083‐0.642) and hypertension during apatinib treatment (P = 0.05) were predictive indicators for apatinib treatment. Grade 3–4 AEs with incidences of 10% or greater were hypertension (21%), hand‐foot syndrome (14%) and proteinuria (11%) which could be relieved by dose reduction. Conclusion: In conclusion, apatinib has a certain therapeutic effect in patients with advanced nonsquamous NSCLC. ECOG performance status and hypertension during apatinib might be predictive indicators for treatment efficacy. [ABSTRACT FROM AUTHOR]