C77-02 A Retrospective Study on the Efficacy and Safety of Anlotinib Combined With Icis Versus Chemotherapy Combined With Icis as First-Line Treatment for Advanced Lung Squamous Cell Carcinoma

Objective To compare the efficacy and safety of anti-angiogenic therapy (represented by anlotinib) combined with immune checkpoint inhibitors (ICIs) versus chemotherapy combined with ICIs as first-line treatment for advanced lung squamous cell carcinoma (LUSC) based on real-world data. Methods We retrospectively analyzed data from patients with advanced LUSC treated at our hospital between 2018 and 2023. Based on the first-line treatment regimen, patients were divided into Group A (anlotinib + ICIs) and Group B (chemotherapy + ICIs). The primary endpoint was median progression-free survival (mPFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), and the incidence of adverse events (AEs). Results A total of 71 eligible cases were included: 37 in Group A and 34 in Group B. The ORR was 56.8% (21/37) and the DCR was 97.3% (36/37) in Group A, with a mPFS of 11.8 months (95% CI: 8.3-NR). In Group B, the ORR was 41.2% (14/34), the DCR was 97.1% (33/34), and the mPFS was 11.8 months (95% CI: 7.4-21.8). There were no statistically significant differences in ORR, DCR (both P > 0.05), or mPFS (HR = 1.35, 95% CI: 0.76-2.37, P = 0.302) between the two groups. Regarding safety, 62.2% (23/37) of patients in Group A experienced treatment-related AEs, with the most common AEs being hypertension (29.7%) and hand-foot syndrome (21.6%). In Group B, the most common AEs were fatigue/anorexia (38.2%), abnormal liver function (20.6%), myelosuppression (17.6%), and rash (11.8%). The incidence of grade ≥3 AEs was 8.1% in Group A and 8.8% in Group B, showing no significant difference (P > 0.05). However, the AE profiles differed: Group A was more prone to AEs associated with VEGF signaling pathway inhibition, while Group B predominantly exhibited abnormal liver function and hematological toxicities. Conclusion In real-world clinical practice, for the first-line treatment of advanced LUSC, the combination of anlotinib and ICIs demonstrated similar efficacy and comparable overall manageable safety compared to chemotherapy combined with ICIs, albeit with distinct AE profiles. Anti-angiogenic therapy combined with immunotherapy may represent a viable first-line treatment option for selected patients with advanced LUSC. This abstract is funded by: None