Anlotinib vs placebo as third- or further-line treatment for patients with small cell lung cancer: a randomised, double-blind, placebo-controlled Phase 2 study

• Published in: British journal of cancer Vol. 125; no. 3; pp. 366 - 371
• Main Authors: Cheng, Ying, Wang, Qiming, Li, Kai, Shi, Jianhua, Liu, Ying, Wu, Lin, Han, Baohui, Chen, Gongyan, He, Jianxing, Wang, Jie, Lou, Donghua, Yu, Hao, Wang, Shanchun, Qin, Haifeng, Li, Xiaoling
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03.08.2021; Nature Publishing Group
• Subjects: 692/4028/67/1612/2143; 692/4028/67/2328; Administration, Oral; Adult; Aged; Biomedical and Life Sciences; Biomedicine; Cancer Research; Chemotherapy; China; Clinical trials; Double-Blind Method; Double-blind studies; Drug Administration Schedule; Drug Resistance; Epidemiology; Female; Humans; Indoles - administration & dosage; Indoles - adverse effects; Lung cancer; Lung Neoplasms - drug therapy; Male; Middle Aged; Molecular Medicine; Oncology; Patients; Placebos; Protein Kinase Inhibitors - administration & dosage; Protein Kinase Inhibitors - adverse effects; Quinolines - administration & dosage; Quinolines - adverse effects; Small cell lung carcinoma; Small Cell Lung Carcinoma - drug therapy; Survival Analysis; Treatment Outcome; Young Adult; China
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/s41416-021-01356-3

Background This study aimed to evaluate the efficacy and safety of anlotinib as a third-line and subsequent treatment for patients with small cell lung cancer (SCLC). Methods We conducted this Phase 2 trial at 11 institutions in China. Patients with pathologically confirmed SCLC who failed at least two lines of chemotherapy were enrolled. Subjects were randomly assigned in a 2:1 ratio to receive either anlotinib 12 mg orally once daily for 14 days every 3 weeks or placebo. The primary endpoint was progression-free survival (PFS). Results Between March 30, 2017 and June 8, 2018, a total of 82 and 38 patients were randomly assigned to receive anlotinib and placebo. The median PFS was significantly longer in the anlotinib group compared with the placebo group (4.1 months [95% confidence interval (CI), 2.8–4.2] vs 0.7 months [95% CI, 0.7–0.8]; hazard ratio (HR) 0.19 [95% CI, 0.12–0.32], p  < 0.0001). Overall survival (OS) was significantly longer with anlotinib than placebo (7.3 months [95% CI, 6.1–10.3] vs 4.9 months [95% CI, 2.7–6.0]; HR 0.53 [95% CI, 0.34–0.81], p  = 0.0029). Conclusions Anlotinib as a third-line or subsequent treatment for Chinese patients with SCLC showed improved PFS and OS than placebo with favourable safety profile. Clinical Trial Registration ClinicalTrials.gov, number NCT03059797.