Clinical analysis of ECOG PS and adverse reactions in patients with anlotinib at advanced NSCLC as the third or further line treatment: a retrospective observational study

Abstract Background: Previous studies have shown that anlotinib be a decent choice in third- or futher line treatment of advanced NSCLC. However, the study anslysis of relationship between Eastern Cooperative Oncology Group performance status(ECOG PS) and adverse reactions in advanced NSCLC with anlotinib therapy is less. Methods: We evaluated the efficacy and toxicity of anlotinib in patients with previously treated advanced NSCLC from June 2018 to March 2019. Survival analysis was performed by the Kaplan–Meier method.Results: According to ECOG PS devided into PS 0-1 group(n=63) and PS 2 group(n=28) . The PS 0-1 of median progression-free survival (mPFS, 5.5 vs.2.7 months, P＜0.05) , overall survival (mOS, 9.2 vs.4.7 months，P＜0.05) was longer than PS 2. The PS 0-1 of objective remission rate(ORR, 45.1% vs 6.6%), disease control rate(DCR, 8.8% vs 1.1%) was significanly more than PS 2. The PS 0-1 group of I-II adverse reactions was high than PS 2 group(52.3% vs 32.1%), but the III-IV adverse reactions were less than PS 2 group(9.5% vs 10.7%). Moreover, multivariate analysis indicated that PS was independent risk factor of PFS（HR=2.816, 95%CI：1.661-4.773，P<0.0001）as well as OS(HR=3.188, 95%CI：1.789-5.682，P=0.0001) for anlotinib therapy in NSCLC. Conclusions: Patients in advanced NSCLC with PS 0–1 get better PFS and OS than PS 2 followed by anlotinib treatment in NSCLC. Advanced lung squamous cell carcinoma(LUSC) recived anlotinib treatment with the same efficacy comparable to adenocarcinoma, and patients with PS 0-1 may benefit the most than PS 2.