Although many strategies have been developed for non-small cell lung cancer (NSCLC), more secondary and further treatments are needed due to drug resistance or tumor recurrence. Apatinib is a novel oral antiangiogenic agent and in this study, we aim to investigate the clinical value of apatinib in heavily pretreated NSCLC. Here, we reported the characteristics, efficacy and adverse events of three patients treated with apatinib (500 mg/day). We also summarized the currently available evidence and ongoing clinical trials regarding the use of apatinib in NSCLC. Two cases of adenocarcinoma and one case of squamous cell carcinoma were treated with apatinib due to disease progression after previous treatments of chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). All patients responded to apatinib rapidly and underwent drug resistance shortly afterwards. The patient with squamous cell carcinoma died of hemoptysis. Other adverse events were acceptable. All previous relevant studies were compared and showed similar results but a longer progression-free survival. Additionally, ongoing clinical trials were systematically searched and listed. In conclusion, apatinib shows some efficacy in heavily treated NSCLC and generally tolerable toxicity in non-squamous NSCLC. More solid evidence will be accessible in near future.
Keywords: ALK, anaplastic lymphoma kinase; Adverse effect; Antiangiogenesis; CT, computed tomography; Clinical trial; EGFR, epidermal growth factor receptor; Efficacy; NSCLC; NSCLC, non-small cell lung cancer; OS, overall survival; PD, progression disease; PET, proton emission tomography; PFS, progression-free survival; PR, partial response; ROS1, ROS proto-oncogene 1; SD, stable disease; TKI, tyrosine kinase inhibitor; VEGF, vascular endothelial growth factor.