Combination Therapy With Apatinib in Resistant NSCLC
On four non–small cell lung cancer cell (NSCLC) lines, gefitinib plus apatinib seemed to strengthen the effect of both agents alone, with H1975 (T790M-resistant) being the most susceptible one. These are the findings of Fang Li, PhD, of Peking University, Beijing, China, and colleagues, who published their study results in the European Journal of Cancer. The investigators now believe that epidermal growth factor receptor–tyrosine kinase inhibitor (EGFR-TKI) rechallenge with apatinib may represent a potential option for patients with NSCLC with T790M or an unknown resistance mechanism.
The four NSCLC cell lines under study included A549 with wild-type EGFR, H1975 harboring L858R and T790M, H1650, and HCC827 harboring E746_A750 deletion. In addition to assessing the effects of apatinib, gefitinib, and the combination of the two agents on these cell lines, the authors also retrospectively evaluated EGFR-TKI rechallenge with apatinib in 16 patients.
In NSCLC with T790M-related EGFR-TKI resistance in both in vivo and in vitro, apatinib appeared to potentiate the antitumor effect of gefitinib. As for EGFR-TKI rechallenge with apatinib, median progression-free survival of 4.60 months was achieved.