Efficacy and safety of apatinib in the second-line treatment of advanced gastric cancer
Journal Title: Chinese Journal of Clinical Research - Year 2025, Vol 38, Issue 1
Abstract
"<b>Objective</b> To explore the efficacy and safety of apatinib in the second-line treatment of advanced gastric cancer, providing a reference to guide treatment decisions for patients with advanced gastric cancer who are unable to endure chemotherapy. <b>Methods</b> A total of 45 patients with advanced gastric cancer, who underwent apatinib treatment after failure of first-line treatment at Jiangsu Cancer Hospital from August 2017 to June 2022, were selected as the subjects for this study. All patients underwent second-line therapy due to failure of first-line therapy. The second-line treatment regimens included four types of combination regimens: apatinib combined with immunotherapy, chemotherapy, immunotherapy plus chemotherapy, antibody-drug conjugate plus chemotherapy, respectively, and patinib monotherapy meanwhile. Survival analysis was performed using the Kaplan-Meier method and log-rank test, while factors influencing median progression-free survival (PFS) were analyzed using the Cox regression model. Stratification factors included gender, age, taking operation or not, microsatellite instability (MMR) status, human epidermal growth factor receptor 2 (HER-2) expression, and programmed cell death receptor 1 (PD-1) / ligand 1 (PD-L1) expression. <b>Results</b> Follow-up untill 2023-12-31, among the 45 patients, the disease control rate (DCR) of apatinib was 48.9%, with a median PFS of 5.0 months. The combination of apatinib with immunotherapy and chemotherapy produced the optimal outcomes, with a median PFS reaching 7.6 months. There was no statistically significant difference in PFS among the various treatment regimens (P＞0.05). Furthermore, the PFS differences among various groups stratified by gender, age, taking operation or not, HER-2 expression, PD-1/PD-L1 expression, and MMR status were also not statistically significant (P＞0.05). The most common adverse reactions were gastrointestinal disturbances (8.9%) and leukopenia (8.9%), but all adverse reactions were manageable. <b>Conclusion</b> Apatinib has some advantages in the second-line treatment of advanced gastric cancer, especially the combination regimen of immunotherapy, chemotherapy and apatinib may bring survival advantages to patients."
Authors and Affiliations
GUO Mengya, CHEN Yue, PENG Weiwei, SHA Huanhuan, FANG Ying, ZHOU Guoren
Keywords
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