Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer

Li, Ningning; Bai, Chunmei; Zhang, Ruixing; Ma, Li; Ren, Xiubao; Zhang, Junping; Fu, Zhanzhao; Zhao, Lin

doi:10.1016/j.tranon.2020.101004

Cited by 16 publications

(15 citation statements)

References 31 publications

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“…However, Wang et al reported that the triplet regimen as first-line chemotherapy improved the prognosis of AFPGC accompanied by liver metastasis [ 14 ]. Li et al and Wang et al reported that apatinib had a good effect on AFPGC [ 15 , 16 ], which is consistent with a case report by Arakawa et al on the efficacy of antiangiogenic therapy of AFPGC [ 17 ]. However, apatinib alone has limited efficacy in treatment of AFPGC.…”

Section: Discussionsupporting

confidence: 83%

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Complete remission of alpha-fetoprotein-producing gastric cancer by combined tislelizumab-apatinib treatment of a patient with proficient mismatch repair: a case report

et al. 2022

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Background Alpha‑fetoprotein-producing gastric cancer (AFPGC) is a rare type of gastric cancer with a high rate of metastasis and poor prognosis. Despite substantial progress in the treatment of many solid tumors, there are no reports of the safety and effectiveness of immune checkpoint inhibitors in combination with antiangiogenesis agents for AFPGC patients who have proficient mismatch repair. Case presentation We describe a 69-year-old man who was diagnosed with metastatic AFPGC. After progression to chemotherapy resistance, tislelizumab combined with apatinib was administered, although the patient’s gastroscopic pathology showed proficient mismatch repair. After three cycles of therapy, partial remission (reduced by 56%) was obtained, and the quality of life improved significantly. Surprisingly, after more than 1 year of continuous application of the combination treatment regimen, both the primary and metastatic tumors in this patient eventually disappeared, which obtained complete remission without surgery. The patient has had a progression-free survival of more than 24 months and is still continuing to benefit. Conclusions This case is the first example of effective treatment of AFPGC with tislelizumab combined with apatinib. The outcomes of this case suggest a highly effective and tolerable therapeutic strategy for microsatellite-stabilized AFPGC.

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Section: Discussionsupporting

confidence: 83%

“…The median progression-free survival of patients administered apatinib was 3.5 months (95% CI : 2.34–4.66). The median overall survival was 4.5 months (95% CI : 3.49–5.51) [ 15 ]. Li et al suggested that PD-1 checkpoint inhibitors plus chemotherapy could be beneficial for AFPGC [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Complete remission of alpha-fetoprotein-producing gastric cancer by combined tislelizumab-apatinib treatment of a patient with proficient mismatch repair: a case report

et al. 2022

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“…Apatinib has been further tested in other therapeutic scenarios. The findings suggested that apatinib combined with paclitaxel-based chemotherapy might be effective and tolerable in patients with chemotherapy-refractory GC (10); apatinib combined with S-1 was not superior to other chemotherapy regimens as first-line therapy for advanced GC (12); apatinib plus neoadjuvant chemotherapy followed by resection in patients with locally advanced gastric adenocarcinoma showed favorable activity and manageable safety (11); apatinib showed promising efficacy and an acceptable safety profile in patients with advanced alpha-fetoprotein-producing GC (13). According to the results of a recent clinical trial, apatinib combined with chemotherapy and PD-1 inhibitor exerted encouraging antitumor activity and manageable toxicity as first-line therapy for patients with advanced or metastatic gastric or gastroesophageal junction adenocarcinoma (14).…”

Section: Gcmentioning

confidence: 99%

Efficacy and Response Biomarkers of Apatinib in the Treatment of Malignancies in China: A Review

2021

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Apatinib is a multitarget tyrosine kinase inhibitor marketed in China for the treatment of advanced gastric cancer (GC) and hepatocellular carcinoma (HCC). It has also been used off-label for the treatment of many other malignancies. To comprehensively evaluate the efficacy of apatinib as a targeted therapy in the treatment of malignancies, we conducted systematic online and manual searches of the literature on apatinib in the treatment of malignancies. In this review, we first summarized the efficacy of apatinib against various malignancies based on clinical trials where results have been reported. In prospectively registered trials, apatinib has been proven to be effective against GC, HCC, lung cancer, breast cancer, sarcoma, esophageal cancer, colorectal cancer, ovarian cancer, cervical cancer, cholangiocarcinoma, diffuse large B-cell lymphoma, nasopharyngeal carcinoma, and differentiated thyroid cancer. The response biomarkers for apatinib were also reviewed. This review will serve as a good reference for the application of apatinib in clinical studies and the design of clinical trials.

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“…in 2021, Li reported that three patients received oral Apatinib 500 mg once a day combined with XELOX (Oxaliplatin/Capecitabine). One patient reached PR with progression-free survival(PFS) for more than 13 months in the first line treatment, and the other for 7 months, the third one had PFS for 3 months ( 11 ). Arakawa also reported that Ramucirumab targeting Vascular Endothelial Growth Factor Receptor 2 (VEGFR2) had some efficacy in AFPGC patients with an OS of 16 months ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Significant response to PD-L1 inhibitor after resistance to PD-1 inhibitor in an advanced alpha-fetoprotein-positive gastric cancer

et al. 2022

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Alpha-fetoprotein-positive gastric cancer (AFPGC) is a type of gastric cancer with a high degree of malignancy. The disease is more common in the elderly, with a high prevalence in males and generally atypical clinical manifestations. For advanced patients, the current treatment options are limited and, to date, few cases of advanced AFPGC have been treated successfully with conventional chemotherapy. With the development of molecular biology and immunology, tumor immunotherapy offers more therapeutic options to patients with advanced gastric cancer. This study describes a case of advanced gastric cancer in a young woman with a high blood alpha-fetoprotein (AFP) level (>54,000 ng/mL). The patient showed initial promising results when programmed cell death-1 (PD-1) inhibitor treatment was combined with chemotherapy after systemic chemotherapy failed. When the disease progressed again after 129 days, adjustment of the treatment regimen to Atezolizumab in combination with Irinotecan and Surufatinib capsules achieved partial remission (PR). There were no immune-related pneumonia, myocarditis, or other adverse effects observed. The patient currently has an overall survival of more than 14 months. This case demonstrated that switching from PD-1 inhibitor to programmed cell death-Ligand 1 (PD-L1) inhibitor therapy may overcome potential resistance. It providing a reference for immunotherapy of patients with AFP-positive advanced gastric cancer.

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Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer

Cited by 16 publications

References 31 publications

Complete remission of alpha-fetoprotein-producing gastric cancer by combined tislelizumab-apatinib treatment of a patient with proficient mismatch repair: a case report

Complete remission of alpha-fetoprotein-producing gastric cancer by combined tislelizumab-apatinib treatment of a patient with proficient mismatch repair: a case report

Efficacy and Response Biomarkers of Apatinib in the Treatment of Malignancies in China: A Review

Case report: Significant response to PD-L1 inhibitor after resistance to PD-1 inhibitor in an advanced alpha-fetoprotein-positive gastric cancer

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