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Hongqing Zhuang
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FP04 - Locoregional and Oligometastatic Disease (ID 126)
- Event: WCLC 2020
- Type: Posters (Featured)
- Track: Locoregional and Oligometastatic Disease
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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FP04.05 - Anti-Vascular Drug Anlotinib Combined With SRS Versus SRS Alone for Brain Metastases From NSCLC: A Case Control Study (ID 1227)
00:00 - 00:00 | Presenting Author(s): Hongqing Zhuang
- Abstract
Introduction
Anti-vascular therapy and SRS have both been widely used in tumor treatment. As for the brain metastases, the current research of anti-vascular drugs mainly focuses on the treatment of brain edema and central radiation necrosis (CRN). However, there is no investigation assessing the effect of anti-vascular therapy simultaneously with SRS on the metastatic brain tumor. The difference between clinical efficiency and side effects of anti-vascular drugs combined with SRS versus SRS alone also remains elusive. Anlotinib, as an anti-vascular drug for lung cancer, has been widely used in NSCLC. This case-control study compared patients treated with anlotinib plus SRS to those with SRS alone, hoping to provide reference for the treatment of brain metastatic NSCLC.
Methods
A total of 46 SRS patients with NSCLC brain metastases were collected from October 2017 to June 2019, among which 21 patients (33 lesions) were in the group of anlotinib combined with SRS and 25 patients (35 lesions) were in the SRS-alone group. The first observation indexes included the toxicity and local control of the intracranial hypertension, central radiation necrosis induced by treatment. The second observation index was defined to be the intracranial progression-free survival (iPFS). The differences of intracranial efficacy and toxicity between the two groups were compared.
Results
The results showed that anlotinib significantly relieved the high intracranial pressure symptoms during SRS ( P < 0.05). There was no difference in response rate (RR) between the two groups ( P = 0.289)，and new intracranial lesions are the main reason for the progress. The incidence of CRN was significantly reduced in the SRS plus anlotinib group compared with SRS-alone group (P < 0.05). The iPFS of the combined treatment group was significantly longer than that of the SRS-alone group ( P <0.05).
Conclusion
Compared with SRS alone, the anti-vascular drug anlotinib combined with SRS can reduce the toxicity of radiotherapy during and after treatment, and improve the effect of intracranial therapy.
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P30 - Palliative and Supportive Care (ID 163)
- Event: WCLC 2020
- Type: Posters
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P30.13 - The Effect of Anlotinib Instead of Glucocorticoids for Encephaledema Induced by Brain Metastases in NSCLC Patients With Anti-PD1/PDL1 Therapy (ID 1091)
00:00 - 00:00 | Presenting Author(s): Hongqing Zhuang
- Abstract
Introduction
High-dose glucocorticoids assist in reducing the efficacy of anti-PD1/PDL-1 immunotherapy. However, glucocorticoid treatment is considered as the major treatment choice for encephaledema caused due to brain metastases in non-small cell lung cancer (NSCLC) patients. Therefore, identifying new strategies that not only improve encephaledema, but also influence the efficacy of immunotherapy have become an important issue in conducting immunotherapy in such patients. Hence, in this study, Anlotinib was used to treat encephaledema instead of glucocorticoids to achieve efficacious results, potentially providing a novel treatment in clinical practices.
Methods
Changes in edema index (EI) of encephaledema before and at 1 week after anlotinib treatment, and the changes of symptoms of intracranial hypertension before and at 1 week after anlotinib treatment, as well as during stereotactic radiosurgery (SRS) are the main outcomes of the study.
Results
The findings revealed that anlotinib treatment has evidently reduced the EI of 23 lesions, and effectively ameliorated the symptoms of intracranial hypertension in the patients. The continuity of immunotherapy in patients was influenced by the application of glucocorticoids due to encephaledema. In addition, SRS treatment of intracranial metastases showed no evident symptoms of intracranial hypertension during anlotinib treatment.
Conclusion
Anlotinib treatment can replace glucocorticoids for treating encephaledema, which was induced by anti-PD1/PDL-1 immunotherapy in NSCLC brain matastases patients, prevented the influences of glucocorticoids regarding the efficacy of immunotherapy, allowed the procedures of consequent SRS of intracranial lesions, and therefore provided an effective treatment in such patients.
