Anlotinib maintenance following adjuvant chemotherapy in newly diagnosed stage III–IV patients with epithelial ovarian cancer: a retrospective study

Background and Aims: Anti-angiogenesis therapy with bevacizumab maintenance marginally improved the median progression-free survival (mPFS) of 4.9 months in patients with advanced epithelial ovarian cancer (EOC). Anlotinib, an oral small-molecular anti-angiogenic agent, has been reported to treat platinum-resistant EOC. However, little is known about anlotinib maintenance therapy in newly diagnosed EOC. Methods: This retrospective study included 20 patients with newly diagnosed EOC from a single hospital between January 2020 and December 2021. The primary endpoints were mPFS, the overall response rate (ORR), and the disease control rate (DCR). Adverse reactions to therapy were also assessed. Results: Among all EOC patients, the ORR was 65% (13/20) and the DCR was 95% (19/20), while the mPFS was 14.8 months (95% confidence interval, 11.5–18.0 months). Subgroup analysis revealed a trend toward a prolonged PFS among EOC patients with a wild-type status compared to those harboring BRCA1/2 mutations (14.8 vs. 11.8 months, P = 0.3621). Seven patients (35%) required a dose reduction because of grade 3 or 4 adverse events, which were manageable and tolerable. No anlotinib-related death events were observed. Conclusion: First-line anlotinib maintenance following adjuvant chemotherapy might be a novel therapeutic strategy, especially for BRCA wild-type EOC patients.