Significant efficacy and well safety of apatinib in an advanced liver cancer patient: a case report and literature review

Abstract

Apatinib is a novel and highly selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2. Previous studies have suggested that apatinib is safe and effective in some solid tumors. We report one case with advanced hepatocellular carcinoma (HCC), who received apatinib combined with transhepatic arterial chemotherapy and embolization (TACE), and chemotherapy respectively. TACE was administered three times once a month, using lipiodol 10ml, oxaliplatin 150mg, and tegafur 1g. The dose of apatinib was 500 mg/d from day 4 to 24. After TACE, the patient received chemotherapy of regimen FOLFOX4, oxaliplatin intravenously at 85 mg/m2 on day 1, calcium levofolinate 200 mg/m2 on day 1 and 2, 5-fluorouracil 400 mg/m2 intravenously and 5-fluorouracil 600 mg/m2 intravenously pumped for 22h on day 1 and 2, cycled every two weeks for seven cycles. He took concurrently apatinib with a dose of 500mg daily from 1 to 10 days per cycle. He was confirmed as partial response (PR) by the Response Evaluation Criteria in Solid Tumors (RECIST). The level of serum alpha-fetoprotein (AFP) decreased from 60500 ng/ml to 12.7 ng/ml, and the progression free survival (PFS) time was more than eight months. It indicated that apatinib may be a superior choice for HCC patients.

Efficacy and safety of apatinib treatment for gastric cancer, hepatocellular carcinoma and non-small cell lung cancer: a meta-analysis

“…Overall, multiple clinical reports have shown that apatinib has a certain effect on advanced liver cancer, 23 lung cancer, 24 ovarian cancer, 25 and other types of malignancy. Nonetheless, there is no clinical research involving a large dataset that reveals its efficacy in malignant solid tumors.…”

Advanced alveolar soft part sarcoma responds to apatinib

“…The patient in our study has thus far achieved disease-free status for 12 months. Apatinib has produced promising clinical outcomes in several other types of cancer [ 39 – 43 ], and has a high binding affinity relative to other anti-angiogenic drugs. For example, apatinib ligand-receptor binding is 10 times greater than that of sorafenib [ 44 , 45 ].…”

Precision medicine for hepatocellular carcinoma: driver mutations and targeted therapy

“…Apatinib has been proved effective in many solid tumors, such as gastric cancer, breast cancer and non-small-cell lung cancer [ 92 ]. Apatinib might also be an optional agent for HCCs at stage C because the median PFS was more than 8 months and the alpha-fetoprotein level was significantly decreased [ 93 ]. A single-arm phase II trial of second-line axitinib demonstrated that this inhibitor could achieve 42.3% of tumor control at 16 weeks and further study should be performed to combine the biomarker responses [ 94 ].…”