Liu WM, Liu YR, Peng Y, Tang J, Li XB. Combination of anlotinib and albumin-bound paclitaxel in 2nd line and above treatment of advanced gastric cancer: A retrospective study. World J Clin Oncol 2025; 16(4): 102199 [DOI: 10.5306/wjco.v16.i4.102199]
Corresponding Author of This Article
Xiao-Bing Li, MD, PhD, Assistant Professor, Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 116 South Zhuodaoquan Road, Hongshan District, Wuhan 430079, Hubei Province, China. lixiaobing0629@126.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Apr 24, 2025; 16(4): 102199 Published online Apr 24, 2025. doi: 10.5306/wjco.v16.i4.102199
Combination of anlotinib and albumin-bound paclitaxel in 2nd line and above treatment of advanced gastric cancer: A retrospective study
Wen-Ming Liu, Yi-Rui Liu, Yi Peng, Jing Tang, Xiao-Bing Li
Wen-Ming Liu, Department of Gastrointestinal Surgery, The First People’s Hospital of Tianmen, Tianmen 431700, Hubei Province, China
Yi-Rui Liu, Department of Nursing, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China
Yi Peng, Department of Radiotherapy, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China
Jing Tang, Department of Lymphoma, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China
Xiao-Bing Li, Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei Province, China
Author contributions: Liu WM drafting manuscripts; Liu YR and Peng Y analyzing and collecting data; Tang J sampling and testing; Li XB supervising the implementation of clinical study.
Supported by Natural Science Foundation of Hubei Province, No. 2019CFC929.
Institutional review board statement: The authors bear full responsibility for ensuring the accuracy and integrity of all aspects of the study. Any queries regarding the precision or honesty of any part of the work were duly investigated and addressed. The study adhered to the principles outlined in the Declaration of Helsinki (revised in 2013). Approval for this retrospective trial was obtained from the Ethics Committee of Hubei Cancer Hospital Affiliated with Tongji Medical College (Wuhan, China) (Approval No. LLHBCH2024YN-092).
Informed consent statement: After review by the Ethics Committee of Hubei Cancer Hospital Affiliated with Tongji Medical College (Wuhan, China), the informed consent was waived.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Bing Li, MD, PhD, Assistant Professor, Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 116 South Zhuodaoquan Road, Hongshan District, Wuhan 430079, Hubei Province, China. lixiaobing0629@126.com
Received: October 11, 2024 Revised: November 13, 2024 Accepted: January 15, 2025 Published online: April 24, 2025 Processing time: 165 Days and 22.4 Hours
Abstract
BACKGROUND
Chemotherapy combined with anti-angiogenic therapy has become an important strategy for the treatment of advanced gastric cancer (AGC); however, the regimen needs optimization.
AIM
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.
METHODS
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).
RESULTS
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.
CONCLUSION
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.
