Analysis of the Clinical Efficacy and Safety of Anlotinib and Erlotinib in the Treatment of Advanced Non-squamous Non-small Cell Lung Cancer

OBJECTIVE To compare the clinical efficacy and safety of anlotinib and erlotinib in the patients with advanced non-squamous non-small cell lung cancer(NSCLC) patients. METHODS Retrospective analysis and screening of 106 patients with advanced non-squamous NSCLC with positive epidermal growth factor receptor(EGFR) gene sensitive mutation diagnosed and treated in the Affiliated Hospital of Nantong University from October 2018 to September 2019. According to the medication situation of the patients, 53 patients were divided into the anlotinib group and the erlotinib group. The oral doses of the patients were 12 mg·d^-1 of anlotinib and 150 mg·d^-1 of erlotinib until progress, death or intolerance of adverse reactions occurred. The therapeutic effect and survival time of the patients were observed. RESULTS In the anlotinib group, complete response was observed in 2 patient(3.8%), partial response was observed in 4 patients(7.5%), stable disease was observed in 34 patients(64.2%), and progressive disease was observed in 13 patients(24.5%), response rate was 11.3% and disease control rate was 75.5%. The median overall survival was 10.3 months and the 1-year survival rate was 45.1%. In the erlotinib group, complete response was observed in 2 patient(3.8%), partial response was observed in 2 patient(3.8%), stable disease was observed in 31 patients(58.5%), and progressive disease was observed in 18 patients(33.9%), response rate was 7.6% and disease control rate was 66.1%. The median overall survival was 8.6 months and the 1-year survival rate was 38.2%. There was no significant difference between the two groups. The multivariate analysis showed that the survival time was associated with PS score and lymph node metastasis(P=0.002 and 0.003). There were significant differences in hypertension, elevated transaminase and diarrhea between the two groups(P<0.05). The overall adverse reactions and grade 3-4 adverse reactions in the anlotinib group were lower than that of erlotinib. CONCLUSION The clinical efficacy of anlotinib in the patients with advanced non-squamous NSCLC is not inferior to erlotinib, and its tolerability is better than erlotinib.