Observation and analysis of the clinical effects of apatinib mesylate tablets in the treatment of advanced late stage non-small cell lung cancer

Objective To observe the curative effects and toxic side effects of Apatinib mesylate tablets in the treatment of advanced late stage non-small cell lung cancer (NSCLC). Methods Clinical data of 21 patients with advanced NSCLC in Changhai Hospital Affiliated to the Naval Military Medical University who were treated by Apatinib mesylate tablets as third line or more than third line therapy during March 2016 and March 2017 was collected and analyzed.They were given oral medication of Apatinib mesylate tablets until progressive disease or intolerant toxic side effects. Results 7 cases achieved partial response (33.3%), 7 cases achieved stable disease (33.3%), and 7 cases achieved progressive disease (33.3%) in 21 cases, representing an overall response rate of 33.3% and a disease control rate of 66.7%.P53 protein positive group was higher in overall response rate and disease control rate than P53 protein negative group (46.2% versus 12.5%, 76.9% versus 50.0%), which without significant differences (χ2=2.524, 1.615, both P>0.05). The mean progression free survival (PFS) was 2.4 (0-6) months after treatment.The PFS was positively correlated with the expression proportion of P53 protein (r2=0.288, P<0.05) in cancer tissue.The median PFS of the P53 protein positive group and P53 protein negative group were 3.45 (0~6) months and 1.08 (0~3) respectively and the difference was statistically significant (HR=0.13, 95%CI: 0.033 6 to 0.535 7, P<0.05). Adverse reactions included 8 cases of hypertension, 6 cases of hand foot syndrome, 5 cases of hemoptysis, 5 cases of fatigue, 2 cases of proteinuia, 2 cases of oral ulcers, 1 cases of renal insufficiency, 1 cases of tracheoesophageal fistula, Ⅰ/Ⅱ grade toxic and side effects were mainly occurred (80%). The toxic and side effects were improved after dose reduction and Apatinib were maintained in 13 cases. Conclusions Apatinib mesylate in the treatment of advanced late stage NSCLC has certain therapeutic effect, which is superior in the patients with P53 protein positive expression.Its adverse reaction can be tolerated after symptomatic treatment or dose adjustment.This antiangiogenic small molecular target TKI could be an alternative agent against advanced NSCLC. Key words: Apatinib mesylate; Non-small cell lung cancer, advanced; Clinical effect; Side effect