Effectiveness and safety of low‐dose apatinib in advanced gastric cancer: A real‐world study

Abstract

Apatinib has been demonstrated to be effective and safe among patients with gastric cancer failing after at least two lines chemotherapy. This study aimed to evaluate its effectiveness and safety of low‐dose apatinib for the treatment of gastric cancer in real‐world practice. We performed a prospective, multicenter observation study in a real‐world setting. Patients with advanced gastric cancer more than 18 years old were eligible and received low‐dose apatinib (500 mg or 250mg per day) therapy. The median progression‐free survival (PFS), median overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety were assessed. Between September 2017 and April 2019, a total of 747 patients were enrolled. The mPFS was 5.56 months (95% CI 4.47‐6.28), and mOS was 7.5 months (95% CI 6.74‐8.88). Four patients achieved complete response, 47 achieved partial response, and 374 patients achieved stable disease. The ORR was 6.83% and DCR was 56.89%. In addition, multivariate Cox regression analysis indicated that hand‐foot syndrome was one independent predictor for PFS and OS. The most common adverse events (AEs) at any grade were hypertension (36.55%), proteinuria (10.26%), hand‐foot syndrome (33.53%), fatigue (24.9%), anemia (57.35%), leukopenia (44.49%), thrombocytopenia (34.21%), and neutropenia (53.33%). Grade 3‐4 AEs with incidences of 5% or greater were anemia (13.97%), thrombocytopenia (7.14%), and neutropenia (6.67%). No treatment‐related death was observed during the treatment of apatinib. The prospective study suggested that low‐dose apatinib was an effective regimen for the treatment of advanced gastric cancer with tolerable or controlled toxicity in real world. Trial registration: NCT03333967.

Combining apatinib and temozolomide for brainstem glioblastoma: a case report and review of literature

“…Previous studies have shown that combined antiangiogenic therapy plus TMZ can significantly improve the survival rate when compared with TMZ monotherapy (20,21). In addition, the efficiency and safety of a low dose have been confirmed in other solid tumors, including nonsmall cell lung cancer, ovarian cancer, and gastric carcinoma (22)(23)(24). That is to say, to the best of our knowledge, we present the first case of low-dose apatinib combined with dose-dense TMZ for the treatment of adult brainstem glioblastoma.…”

Elemene-containing hyperthermic intraperitoneal chemotherapy combined with chemotherapy for elderly patients with peritoneal metastatic advanced gastric cancer

“…Lastly, a control group for systemic chemotherapy should also be considered. Finally, it has been reported that NCT03333967[ 36 ], TAGS[ 37 ] and EPOC1201[ 38 ] can improve the prognosis of patients with advanced GC. Therefore, in future studies, it should be determined whether elemene-containing HIPEC can improve the therapeutic effects of these drugs.…”

“Highly Exposed Chinese Herbal Medicine” Combined With Apatinib as Maintenance Treatment Following First-Line or Second-Line Chemotherapy for Extensive-Stage Small-Cell Lung Cancer: A Single-Arm, Prospective Study

“…Previous studies have demonstrated that hand-foot syndrome is one of the most common side-effects of anti-VEGF treatment, which has also been suggested as a biomarker predicting the responses and prognoses of anti-VEGF treatment. 32 …”

“…Previous studies have demonstrated that hand-foot syndrome is one of the most common side-effects of anti-VEGF treatment, which has also been suggested as a biomarker predicting the responses and prognoses of anti-VEGF treatment. 32 The dose of apatinib in different previous clinical trials on solid tumors ranged from 500 to 750 mg once per day. 33,34 Therefore, the initial dose of apatinib in this study was 500 mg once per day.…”