DISCUSSION
NSCLC, SCLC, vascularized malignant tumors, tumor, toxicity, lung cancer, gastric cancer
COLORECTAL CANCER, TUMOR, SCLC, PROLIFERATION, DISEASE, LUNG CANCER, HEPATOCELLULAR CARCINOMA, NSCLC, GASTRIC CANCER
Over the past two decades, antiangiogenic therapy has gained increasing attention because of its success in resisting multiple vascularized malignant tumors, such as colorectal cancer, NSCLC, and hepatocellular carcinoma.Herein, we used an oral small molecular antiangiogenic TKI apatinib in combination with chemotherapy as second‐line therapy for the treatment of advanced pretreated SCLC. Regarding the potential mechanism of this combination therapy, firstly, since VEGF plays a key role in angiogenesis and apatinib could exert its antigenic effect by inhibiting its induced endothelial cell proliferation and migration by targeting VEGFR2 with high selectivity.In our study, the majority of the patients presented partial response or stable disease. This new regimen showed better efficacy and tolerable toxicity for second‐line treatment of SCLC patients compared with the standard second‐line chemotherapies. In our study, PFS (7.36 months) and OS (14.16 months) were significantly longer than other therapies, such as topotecan, amrubicin, irinotecan, etc. Moreover, no intolerable AEs were observed in our study compared with other standard second‐line regimens (Table A similar retrospective study investigated the efficacy of induction chemotherapy in combination with apatinib (250 mg/day) as maintenance therapy in extensive‐stage SCLC and found that the PFS was 8.3 months and the OS was 17 months.The recommended dose of apatinib for advanced gastric cancer is 850 mg/day.As a highly selective VEGFR2 inhibitor, apatinib shows multidrug resistance and is also resistance to angiogenesis. In addition, it acts on tumor cells directly and enhances the sensitivity of chemotherapeutics.In addition, we estimated that the proportion of patients with this limited stage ranged from 20% to 40% by reviewing previous studies on second‐line treatment of SCLC.Nevertheless, the present study has some limitations. In addition to the small sample size, this study did not have a control group. Thus, it could not be concluded that the combination regimen is superior to apatinib or chemotherapy alone in this study. However, the advantages of apatinib combined with chemotherapy have been proven in other lung cancer studies.