Apatinib combined with chemotherapy or concurrent chemo-brachytherapy in patients with recurrent or advanced cervical cancer

Guo, Qiufen; Sun, Yawen; Kong, Enqi; Rao, Linli; Chen, Jinlong; Wu, Qian; Zhang, Tingting; Liu, Naifu; Li, Mingjiang; Sun, Li

doi:10.1097/md.0000000000019372

Cited by 17 publications

(8 citation statements)

References 36 publications

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“…After screening and qualification evaluation, 23 clinical trials involving 6,241 patients were finally included after excluding review articles, case reports, and meta-analysis articles, with the flow chart of literature selection shown in Figure 1 . Of the 23 studies, there were 12 phase II, 11 phase III, and 1 phase IV trials, with the year of publication ranging from 2005 to 2020 ( Table 1 ) ( Miller et al, 2005 ; Heymach et al, 2008 ; Goss et al, 2010 ; Mok et al, 2011 ; Rugo et al, 2011 ; Baselga et al, 2012 ; Kato et al, 2012 ; Johnston et al, 2013 ; Laurie et al, 2014 ; Liu et al, 2014 ; Mackey et al, 2015 ; Rini et al, 2016 ; Baselga et al, 2017 ; Kubota et al, 2017 ; Yan et al, 2017 ; Dummer et al, 2018 ; Lu et al, 2018 ; Liu et al, 2019 ; Nakagawa et al, 2019 ; Cortot et al, 2020 ; Guo et al, 2020 ; Sinn et al, 2020 ; Tao et al, 2020 ). According to the published Common Terminology Criteria for Adverse Events (CTCAE) by the National Cancer Institute (NCI), hypertension caused by anti-cancer treatment includes 5 grades of grade 1–5 ( Table 2 ) ( National Cancer Institute, 2017 ).…”

Section: Resultsmentioning

confidence: 99%

Hypertension Induced by Combination Therapy of Cancer: A Systematic Review and Meta-Analysis of Global Clinical Trials

et al. 2021

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Background: Nowadays, due to the limitation of single therapy, combination therapy for cancer treatments has become important strategy. With the advancement of research on cardiotoxicities induced by anti-cancer treatment, among which cancer treatment-induced hypertension is the most frequent case. However, due to the small sample size and the absence of comparison (single-arm study alone), these studies have limitations to produce a feasible conclusion. Therefore, it is necessary to carry out a meta-analysis focusing on hypertension caused by cancer combination therapy.Methods: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and CNKI, from database inception to November 31, 2020, with randomized controlled trials (RCTs) associated with hypertension induced by cancer combination drugs. The main endpoint of which was to assess the difference in the incidence of hypertension in cancer patients with monotherapy or combination therapy. We calculated the corresponding 95% confidence interval (95% CIs) according to the random effect model and evaluated the heterogeneity between different groups.Results: According to the preset specific inclusion and exclusion criteria, a total of 23 eligible RCTs have been included in the present meta-analysis, including 6,241 patients (Among them, 2872 patients were the control group and 3369 patients were the experimental group). The results showed that cancer patients with combination therapy led to a higher risk of hypertension (All-grade: RR 2.85, 95% CI 2.52∼3.22; 1∼2 grade: RR 2.43, 95% CI 2.10∼2.81; 3∼4 grade: RR 4.37, 95% CI 3.33∼5.72). Furthermore, compared with the control group who received or did not receive a placebo, there was a higher risk of grade 3-4 hypertension caused by cancer combination treatment.Conclusion: The present meta-analysis carries out a comprehensive analysis on the risk of patients suffering from hypertension in the process of multiple cancer combination therapies. Findings in our study support that the risk of hypertension may increase significantly in cancer patients with multiple cancer combination therapies. The outcomes of this meta-analysis may provide a reference value for clinical practice and may supply insights in reducing the incidence of hypertension caused by cancer combined treatment.

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Section: Resultsmentioning

confidence: 99%

Hypertension Induced by Combination Therapy of Cancer: A Systematic Review and Meta-Analysis of Global Clinical Trials

et al. 2021

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“…In 2019, several studies reported the effect of single‐agent apatinib treatment after failure of first‐line treatment in recurrent or advanced cervical cancer. 17 , 19 , 20 , 21 In 2020, Guo et al 22 assessed the clinical efficacy and safety of apatinib combined with chemotherapy or concurrent chemo‐brachytherapy as first‐line treatment. In comparison to the results from these studies, ORR, DCR and median PFS, and OS of our study seems a slightly higher than those reported in 2019, but lower than the finding from Guo et al in 2020.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and prognostic factors of apatinib treatment in patients with recurrent or advanced cervical carcinoma: A retrospective study

et al. 2021

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Background Apatinib is an oral anti‐angiogenic drug, its efficacy and prognosis in cervical carcinoma are unclear. This study evaluates the effectiveness and prognostic factors of apatinib in the treatment of recurrent or advanced cervical carcinoma. Methods Patients with recurrent or advanced cervical cancer, who agreed to take apatinib, were recruited into this single‐center and retrospective study, and administrated apatinib with or without combination of chemo‐ or radio‐therapy until progressive disease (PD) or unacceptable toxicity. Results From March 2017 to February 2019, 53 patients were reviewed. Among them, 2 (3.77%) patients occurred complete response, 16 (30.19%) patients showed partial response, 27 (50.95%) patients had stable disease, and 8 (15.09%) patients had PD. The objective response rate and disease control rate (DCR) of these patients were 33.96% and 84.91%, respectively. The DCR of patients younger than 50, nonsquamous carcinoma, first‐line apatinib therapy, combined radiotherapy, lesions within radiation field, surgical history, and Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 were significantly higher than other patients (p < 0.05). The median progression‐free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.43–7.57) and 8.0 months (95% CI: 6.52–9.48), respectively. The univariable and multivariable analysis showed that the patients with an ECOG performance status score of 2 and further line therapy were associated with poor prognosis in both PFS and OS (PFS: HR =8.35, p = 0.000; HR =6.66, p = 0.001; OS: HR = 7.40, p = 0.000; HR = 3.24, p = 0.039), respectively. The most common adverse effects (AEs) were hand‐foot syndrome (35.58%), hypertension (18.87%) and fatigue (15.09%). No grade 3 AEs and drug‐related death occurred. Conclusion The efficacy and prognosis of patients who are in good general condition and first‐line apatinib combination therapy may be better than other patients. But further phase III clinical trials should be taken to prove this hypothesis.

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“…Neratinib was generally well tolerated in the SUMMIT study and no new safety signals were identified. The efficacy of neratinib monotherapy was encouraging and, even though crosstrial comparisons are problematic, the ORR of 25%, CBR of 50%, and median PFS of 7.0 months observed in SUMMIT compare favorably with those reported for platinum-based chemotherapy plus bevacizumab [27,36] and other investigational agents tested in this setting including newer anti-VEGF and anti-PD-L1 therapies, such as apatinib [18,37], nivolumab [38], and pembrolizumab [28,29].…”

Section: Discussionmentioning

confidence: 87%

Neratinib in patients with HER2-mutant, metastatic cervical cancer: findings from the phase 2 SUMMIT ‘basket’ trial

D'souza

Roman

Saura

et al. 2019

Gynecologic Oncology

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Objective.-Somatic HER2 mutations occur in ~5% of cervical cancers and are considered oncogenic and associated with poor prognosis. Neratinib, an irreversible pan-HER tyrosine kinase inhibitor, is active in multiple HER2-mutant cancers. SUMMIT is a phase II basket trial investigating the efficacy and safety of neratinib in solid tumors.Methods.-Patients with HER2-mutant, persistent, metastatic/recurrent cervical cancer with disease progression after platinum-based treatment for advanced/recurrent disease received oral neratinib 240 mg/day with mandatory loperamide prophylaxis during cycle 1. The primary endpoint was confirmed objective response rate (ORR). Secondary endpoints included: response duration (DOR); clinical benefit rate (CBR); progression-free survival (PFS); overall survival (OS); safety.Results.-Sixteen eligible patients were enrolled; 10 (62.5%) had endocervical adenocarcinoma. The most common HER2 mutation was S310F (63% of patients). Three of 12 RECIST-measurable patients had confirmed partial responses (ORR 25%; 95%CI 5.5-57.2%); 3 had stable disease ≥16 weeks (CBR 50%; 95%CI 21.1-78.9%). DOR for responders were 5.6, 5.9, and 12.3 months. Median PFS was 7.0 months (95%CI 0.7-18.3 months); median OS was 16.8 months (95%CI 4.1-Oaknin et al.

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Apatinib combined with chemotherapy or concurrent chemo-brachytherapy in patients with recurrent or advanced cervical cancer

Cited by 17 publications

References 36 publications

Hypertension Induced by Combination Therapy of Cancer: A Systematic Review and Meta-Analysis of Global Clinical Trials

Hypertension Induced by Combination Therapy of Cancer: A Systematic Review and Meta-Analysis of Global Clinical Trials

Effectiveness and prognostic factors of apatinib treatment in patients with recurrent or advanced cervical carcinoma: A retrospective study

Neratinib in patients with HER2-mutant, metastatic cervical cancer: findings from the phase 2 SUMMIT ‘basket’ trial

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