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. 2022 Jul 28:12:939343.
doi: 10.3389/fonc.2022.939343. eCollection 2022.

A real-world study of anlotinib as third-line or above therapy in patients with her-2 negative metastatic breast cancer

Yingbo Shao  1   2 , Zhifen Luo  3   4 , Yang Yu  1   2 , Yaning He  1   2 , Chaojun Liu  1   2 , Qi Chen  1   2 , Fangyuan Zhu  1   2 , Bing Nie  1   2 , Hui Liu  1   2
Affiliations

A real-world study of anlotinib as third-line or above therapy in patients with her-2 negative metastatic breast cancer

Yingbo Shao et al. Front Oncol. .

Abstract

Background: Antiangiogenic agents provides an optional treatment strategy for patients with metastatic breast cancer. The present study was conducted to evaluate the efficacy and safety of anlotinib as third-line or above therapy for patients with HER-2 negative metastatic breast cancer.

Methods: Patients with HER-2 negative metastatic breast cancer who have failed from prior therapy and treated with anlotinib monotherapy or combined with chemotherapy or immunotherapy from June 2018 to December 2020 were retrospectively analyzed based on real-world clinical practice. The primary end point was progression free survival (PFS). Secondary end points included objective response rate (ORR), disease control rate (DCR), overall survival (OS) and safety.

Results: 47 patients with HER-2 negative metastatic breast cancer received anlotinib monotherapy or combination therapy as third-line or above therapy. In the general population, 10 patients achieved PR, 25 patients had SD and 12 patients had PD. The overall ORR and DCR were 21.3% and 74.5%, respectively. Subgroup analysis suggested that there were no statistically significant differences in ORR and DCR with respect to HR status (positive vs. negative), treatment programs (monotherapy vs. combination) and treatment type in combination group (chemotherapy vs. immunotherapy). The patients who did not received previously anti-angiogenesis therapy had superior DCR (84.8% vs. 50.0%, P=0.012). Median PFS and OS were 5.0 months (95% CI=4.3-5.7) and 21.0 (95% CI=14.9-27.1) months, respectively. The PFS (6.5m vs. 3.5m, P=0.042)and OS (28.2m vs. 12.6m, P=0.040) were better in HR positive patients than HR negative patients. And simultaneously, patients who received anlotinib combination therapy obtained better PFS (5.5m vs. 3.0m, P=0.045). The incidence of Grade 3-4 adverse events(AEs) was 31.9%.

Conclusions: Anlotinib monotherapy or combination therapy provide a viable third-line or above therapeutic strategy in patients with HER-2 negative metastatic breast cancer, a median PFS of 5.0 months was obtained with well tolerated toxicity.

Keywords: anlotinib; anti-angiogenesis; breast cancer; immunotherapy; safety.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier curve of PFS (A) and OS (B) in the general population who received anlotinib as third-line or above therapy for patients with HER-2 negative metastatic breast cancer.
Figure 2
Figure 2
Kaplan-Meier curve of PFS (A) and OS (B) in patients with different HR status (HR positive vs. HR negative). Kaplan-Meier curve of PFS (C) and OS (D) in patients with different treatment programs (monotherapy vs. combination therapy). Kaplan-Meier curve of PFS (E) and OS (F) in patients with different treatment type in combination group (anlotinib + chemotherapy vs. anlotinib + immunotherapy). Kaplan-Meier curve of PFS (G) and OS (H) in patients with or without prior anti-angiogenesis therapy.
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