Clinical Edge

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Apatinib plus gefitinib: Better PFS but more toxicity

Key clinical point: Adding apatinib to gefitinib as first-line treatment in patients with advanced, epidermal growth factor receptor–mutant non–small cell lung cancer improved progression-free survival, but this came at the cost of increased toxicity.

Major finding: The median progression-free survival was 13.7 months in the apatinib-gefitinib group and 10.2 months in the placebo-gefitinib group (hazard ratio, 0.71; P = .0189). The rate of grade 3 or higher treatment-emergent adverse events was 84.1% and 37.7%, respectively.

Study details: A phase 3 trial of 313 patients with locally advanced, metastatic, or recurrent nonsquamous non–small cell lung cancer randomized to apatinib plus gefitinib or placebo plus gefitinib.

Disclosures: The study was funded by Jiangsu HengRui Medicine, the Chinese Thoracic Oncology Group, and grants from Sun Yat-sen University and the National Key R&D Program of China. Dr. Zhang disclosed relationships with AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Pfizer, and Roche.


Zhang L et al. ESMO 2020, Abstract LBA50.