Title : Bevacizumab versus anlotinib respectively combined with chemotherapy drug in the treatment of EGFR-TKI acquired resistant advanced lung adenocarcinoma
Abstract:
Objective: To compare the short-term therapeutic efficacy and safety of bevacizumab versus anlotinib, each in combination with chemotherapy, for the treatment of advanced lung adenocarcinoma with acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).
Methods: A retrospective analysis was conducted on 84 patients with EGFR-TKI-resistant advanced lung adenocarcinoma treated at the Third People's Hospital of Chengdu between June 2019 and October 2021. Patients were divided into three groups: chemotherapy alone (32 cases), anlotinib plus chemotherapy (24 cases), and bevacizumab plus chemotherapy (28 cases). The chemotherapy group received pemetrexed disodium and carboplatin, with symptomatic management for adverse events. The anlotinib combination group received oral anlotinib hydrochloride 10 mg once daily (14 days on, 7 days off) starting on the first day of chemotherapy, in addition to the chemotherapy regimen. The bevacizumab combination group received intravenous bevacizumab 15 mg/kg one day before chemotherapy, in addition to the chemotherapy regimen. All groups completed four 3-week cycles. Outcomes included overall response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), changes in serum tumor markers, incidence of adverse events, and 1-year survival rate.
Results: After four cycles, the ORR and DCR were significantly higher in both combination therapy groups than in the chemotherapy alone group (P< 0.05). The mPFS was also significantly longer in both combination groups than in the chemotherapy alone group, and the DCR was significantly higher in the anlotinib combination group than in the bevacizumab combination group (P< 0.05). Serum tumor marker levels decreased significantly in all three groups after treatment, with greater reductions observed in the combination therapy groups (P< 0.05). There were no significant differences in the incidence of adverse events (including nausea, vomiting, and bone marrow suppression) or 1-year survival rate among the three groups (P> 0.05).
Conclusions: Both bevacizumab and anlotinib, when combined with chemotherapy, are effective and well-tolerated treatments for advanced lung adenocarcinoma with acquired EGFR-TKI resistance.
