The Efficacy of Anlotinib Plus Whole Brain Radiotherapy in Advanced Non-Small Cell Lung Cancer With Multiple Brain Metastases: A Retrospective Study.

This study aimed to compare the efficacy of anlotinib plus whole-brain radiotherapy (WBRT) with that of WBRT alone in non-small cell lung cancer (NSCLC) patients with multiple brain metastases (BMs). The clinical data of patients with NSCLC and multiple BMs who received WBRT between 2019 and 2022 were collected. The patients were assigned to anlotinib plus WBRT group and WBRT group according to the treatment used. A total of 64 patients were eligible for analysis; 21 were treated with anlotinib plus WBRT, and 43 were treated with WBRT. The anlotinib plus WBRT group had a greater proportion of patients who were young and had a better performance status and adenocarcinoma histology than did the WBRT group. The median follow-up time was 18.0 months. The median intracranial progression-free survival (iPFS) was significantly longer in the anlotinib plus WBRT group than in the WBRT group (12.9 months vs. 7.4 months, p = 0.004). The median overall survival (OS) was 14.6 months in the anlotinib plus WBRT group and 9.4 months in the WBRT group (p = 0.039). Considering death as a competing risk to intracranial progression, the 1-year cumulative incidence of intracranial progression in the anlotinib plus WBRT group (26.7%) was significantly lower than that in the WBRT group (64.3%) (p = 0.021). There was no significant difference in treatment-related toxicity between the anlotinib plus WBRT group and the WBRT group. Compared with WBRT alone, anlotinib plus WBRT might confer superior intracranial PFS for NSCLC patients with multiple BMs without increasing treatment-related toxicity.

Liu L ，Xu Y ，Gao H ，Zhao T ，Chen D ，Jin J ，Gao C ，Li G ，Zhong Q ... -  《-》

A phase II study of anlotinib plus whole brain radiation therapy for patients with NSCLC with multiple brain metastases.

Gu D ，Yu H ，Ding N ，Xu J ，Qian P ，Zhu J ，Jiang M ，Tao H ，Zhu X ... -  《-》

Whole-Brain Radiotherapy Simultaneous Integrated Boost Intensity-Modulated Radiotherapy Combined With Anlotinib in the Treatment of Brain Metastases.

Tao W ，Jiang C ，Xie J ，Liu W ，Wang S ，Zhang J ，Qiao X ，Yu J ，Jia T ，Cao Y ... -  《-》

Effects of EGFR-TKIs combined with intracranial radiotherapy in EGFR-mutant non-small cell lung cancer patients with brain metastases: a retrospective multi-institutional analysis.

Patients with non-small cell lung cancer (NSCLC) are prone to developing brain metastases (BMs), particularly those with epidermal growth factor receptor (EGFR) mutations. In clinical practice, treatment-naïve EGFR-mutant NSCLC patients with asymptomatic BMs tend to choose EGFR-tyrosine kinase inhibitors (TKIs) as first-line therapy and defer intracranial radiotherapy (RT). However, the effectiveness of upfront intracranial RT remains unclear. This was a retrospective study including 217 patients from two institutions between January 2018 and December 2022. Clinical data of NSCLC patients with BMs who received EGFR-TKIs were collected. The patients were assigned to one of the three groups according to the therapeutic modality used: the upfront TKI + stereotactic radiosurgery (SRS) / fractionated stereotactic radiotherapy (fSRS) group (upfront TKI + SRS/fSRS ), the upfront TKI + whole-brain radiotherapy (WBRT) group (upfront TKI + WBRT) and the upfront TKI group. As of March 8, 2023, the median follow-up duration was 37.3 months (95% CI, 32.5-42.1). The median overall survival (OS) for the upfront TKI + SRS/fSRS, upfront TKI + WBRT, and upfront TKI groups were 37.8, 20.7, and 24.1 months, respectively (p = 0.015). In subgroup analysis, the upfront TKI + SRS/fSRS group demonstrated longer OS compared to the upfront TKI + WBRT and upfront TKI groups in patients treated with first or second-generation EGFR-TKIs (p = 0.021) and patients with L858R mutation (p = 0.017), whereas no survival benefit was observed in three-generation EGFR-TKIs or 19del subgroup. In the multivariable analysis, metachronous BMs, EGFR L858R mutation and nonclassic EGFR mutation were identified as independent risk factors for OS, while a DS-GPA score of 2.0-4.0 was the only independent protective factor. This study demonstrated that upfront addition of SRS/fSRS to EGFR-TKIs was associated with longer OS compared to upfront WBRT or upfront TKI alone in EGFR-mutant NSCLC patients with BMs. This improvement was more significant in patients with L858R mutation and those treated with first or second-generation EGFR-TKIs. Further research with a larger sample size is warranted.

He M ，Wu X ，Li L ，Yi G ，Wang Y ，He H ，Ye Y ，Zhou R ，Xu Z ，Yang Z ... -  《Radiation Oncology》

Efficacy and safety of anlotinib monotherapy or combination therapy in the treatment of patients with advanced non-small cell lung cancer: a retrospective real-world study conducted in East China.

Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer-related mortality worldwide. Despite significant advancements in chemotherapy, targeted therapy, and immunotherapy, the prognosis for advanced NSCLC remains poor. The development of resistance to standard treatments and the lack of effective therapeutic options for heavily pretreated patients underscore the urgent need for novel treatment strategies. Angiogenesis plays a pivotal role in tumor growth and metastasis, making it a critical target in cancer therapy. Anlotinib, a novel multi-target tyrosine kinase inhibitor, has demonstrated potent anti-tumor activity in patients with advanced NSCLC. The retrospective analysis was conducted on clinical data from 82 patients with advanced NSCLC who received either anlotinib monotherapy or combination therapy. Patients were divided into two groups based on different treatment modalities: anlotinib monotherapy group (30 patients) and anlotinib combination therapy group (52 patients). The anlotinib combination therapy group received anlotinib in combination with immune checkpoint inhibitors (ICIs), chemotherapy, or targeted drugs. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), and adverse events. Although the difference in ORR between the two groups was not statistically significant (P > 0.05), the DCR was notably higher in the combination therapy group compared to the monotherapy group (86.5% vs. 66.7%, P < 0.05). In the anlotinib combination therapy group, patients demonstrated a significantly longer PFS compared to those in the anlotinib monotherapy group (median PFS: 20.0 m vs. 9.3 m, P = 0.030). The PFS% at 12, 18, and 24 months in the anlotinib combination therapy group were 65.38%, 55.77%, and 28.85%, respectively, all significantly higher than in the anlotinib monotherapy group (P < 0.05). In the combination therapy regimen, anlotinib combined with ICIs significantly prolonged patients' PFS (median PFS: 25.4 m vs. 9.3 m, P < 0.05). Subgroup analysis results indicated that in subgroups of male patients, patients with a history of hypertension, patients with ≥ 3 lines of treatment, and patients without a history of anti-angiogenic therapy, the PFS in the anlotinib combination therapy group was significantly better than in the anlotinib monotherapy group (P < 0.05). Although the incidence of bleeding and skin adverse reactions was higher in the anlotinib combination therapy group compared to the monotherapy group, the difference was not statistically significant (P > 0.05). Anlotinib combination therapy was associated with improved PFS in advanced NSCLC patients, with a tolerable safety profile.

Wei J ，Zhang Y ，Zheng Y ，Ma C ，Zhao Q ，Wang Y ，Miao L ，Ding J ... -  《-》