Published online Apr 24, 2025. doi: 10.5306/wjco.v16.i4.102199
Revised: November 13, 2024
Accepted: January 15, 2025
Published online: April 24, 2025
Processing time: 165 Days and 22.4 Hours
Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer (AGC); however, the re
To evaluate the efficacy of albumin-bound paclitaxel (nab-ptx) combined with the small molecule vascular endothelial growth factor inhibitor anlotinib in second-line and beyond treatment of AGC.
We collected data from AGC patients at our hospital who experienced disease progression after first-line chemotherapy and received anlotinib combined with nab-ptx. The primary endpoints included overall survival (OS) and progression-free survival (PFS), while the secondary endpoints were objective response rate (ORR), disease control rate (DCR), and adverse events (AEs).
Preliminary results indicated that anlotinib combined with nab-ptx can provide significant efficacy in second-line or above treatment for AGC (median PFS = 6.0 months, median OS = 12.0 months), with an ORR of 42% and a DCR of 78%. Further analysis revealed that patients who experienced hypertension, proteinuria, and hand-foot syndrome during treatment had better efficacy compared to those who did not experience these AEs. Mechanistic studies suggest that this regimen likely exerts synergistic anti-tumor effects by activating the immune response through the reduction of regulatory T-cell proportions. Common adverse reactions included bone marrow suppression, peripheral neuropathy, hypertension, proteinuria, and hand-foot syndrome, which were manageable and resolved with appropriate interventions, indicating the promising application of this regimen in second-line or above treatment for AGC.
The combination of anlotinib and nab-ptx shows promising efficacy with fewer toxicities in AGC treatment. The regimen holds promise as a second-line treatment of AGC; however, its specific clinical value requires further research.
Core Tip: The second-line or above treatment for advanced gastric cancer lacks effective therapeutic models. The results of this study indicate that the small molecule vascular endothelial growth factor inhibitor anlotinib combined with albumin-bound paclitaxel has significantly improved efficacy in gastric cancer treatment, and the toxic side effects are manageable. Further analysis showed that patients who experience hypertension, proteinuria, and hand-foot syndrome during treatment derive greater benefit from this regimen. The mechanism of this combination treatment may involve the depletion of immune suppression to activate the immune system, thereby exerting a synergistic anti-tumor effect, demonstrating the potential of this regimen for clinical application.