Combination of anlotinib and albumin-bound paclitaxel in 2nd line and above treatment of advanced gastric cancer: A retrospective study.

BACKGROUND

Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer (AGC); however, the regimen needs optimization.

AIM: To evaluate the efficacy of albumin-bound paclitaxel (nab-ptx) combined with the small molecule vascular endothelial growth factor inhibitor anlotinib in second-line and beyond treatment of AGC.

METHODS

We collected data from AGC patients at our hospital who experienced disease progression after first-line chemotherapy and received anlotinib combined with nab-ptx. The primary endpoints included overall survival (OS) and progression-free survival (PFS), while the secondary endpoints were objective response rate (ORR), disease control rate (DCR), and adverse events (AEs).

RESULTS

Preliminary results indicated that anlotinib combined with nab-ptx can provide significant efficacy in second-line or above treatment for AGC (median PFS = 6.0 months, median OS = 12.0 months), with an ORR of 42% and a DCR of 78%. Further analysis revealed that patients who experienced hypertension, proteinuria, and hand-foot syndrome during treatment had better efficacy compared to those who did not experience these AEs. Mechanistic studies suggest that this regimen likely exerts synergistic anti-tumor effects by activating the immune response through the reduction of regulatory T-cell proportions. Common adverse reactions included bone marrow suppression, peripheral neuropathy, hypertension, proteinuria, and hand-foot syndrome, which were manageable and resolved with appropriate interventions, indicating the promising application of this regimen in second-line or above treatment for AGC.

CONCLUSION

The combination of anlotinib and nab-ptx shows promising efficacy with fewer toxicities in AGC treatment. The regimen holds promise as a second-line treatment of AGC; however, its specific clinical value requires further research.