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

Abstract

Apatinib (Aitan®, brand name in China) is a new anti-antiangiogenic agent that has recently been approved for the treatment of advanced gastric cancer (GC) in China. Nevertheless, its therapeutic efficacy against other types of advanced solid tumors remains unclear. This meta-analysis examines the short-term efficacy and safety of apatinib or combination therapy for GC, hepatocellular carcinoma (HCC) and non-small-cell lung cancer (NSCLC); and provides a discussion of its anti-angiogenesis therapy applications. Seven clinical studies met the inclusion criteria. The treatment of cancers using apatinib was more successful compared to therapy without apatinib. Both objective response rates (ORRs) and disease control rates (DCRs) were significantly improved in the apatinib group compared to those in the control group (RR=2.18, 95% CI 1.30–3.65; RR=2.09, 95% CI 1.21–3.60). The DCR of 850 mg qd and 750 mg qd were higher than those in the control group (P<0.05). Based on the short-term acute adverse reactions of apatinib, significant differences between groups were found for hypertension, urine protein, hand foot syndrome, and gastrointestinal reactions (diarrhea), while no significant differences were found for myelosuppression, nausea and vomiting. Moreover, the results showed that apatinib prolonged patient survival (HR=0.38, 95% CI: 0.28–0.52), and the effect was more pronounced in patients treated with 750 mg qd or 850 mg qd of apatinib than in those treated with a dose of ≤500 mg qd. Additionally, compared to its second-line application, the third-line application was shown to further reduce the risk ratio in patients. Furthermore, overall survival was longer in patients treated with apatinib. Apatinib was shown to have certain short-term effects and survival benefits on GC, HCC, and NSCLC with controllable adverse effects.

Pharmacokinetic interaction between a Chinese herbal formula Huosu Yangwei oral liquid and apatinib in vitro and in vivo

“…This study focuses on the in‐vitro and in‐vivo investigations on the pharmacokinetic interactions between a herbal product HSYW and apatinib, a newly approved TKI that is used to treat advanced‐stage gastric cancer in China with the recommended dosage of 850 mg for adult patients. [ 10 ] In clinical settings, patients with advanced‐stage gastric cancer are frequently administered with multiple medications (including some herbal medicines), and thus, the potential herb–drug interactions should be investigated extensively. Notably, HSYW, an herbal product developed in the 1990s, has been frequently used in combination with apatinib for the treatment of patients with advanced‐stage gastric cancer in several Chinese hospitals.…”

“…The incubation system included potassium phosphate buffer (pH 7.4, 100 m m ), apatinib (2.0 μ m , final concentration), HLM (0.2 mg/ml, final concentration) or RLM (0.2 mg/ml, final concentration), and NADPH‐generating system, as reported previously. [ 9–10 ] Before inhibition assays, the formation of two oxidative metabolites of apatinib was validated in the linear range of reaction time and microsomal protein concentration. In brief, HSYW (0.2555 mg dried materials/ml to 7.9835 mg dried materials/ml, final concentration) was added to the incubation system for 10 min pre‐incubation at 37°C.…”

“…Apatinib, a novel small‐molecule tyrosine kinase inhibitor, has been approved to treat metastatic gastric cancer by Chinese State Food and Drug Administration. [ 10–16 ] The major metabolites of apatinib in the human body are two oxidative metabolites (M1‐1 and M1‐6), as well as the glucuronide of M1‐1 (M9‐2). [ 17 ] A previous study has demonstrated that apatinib is mainly metabolized by CYP3A4/5 while CYP2D6, CYP2C9 and CYP2E1 contribute to a lesser extent.…”

Immune checkpoint blockade therapies for HCC: current status and future implications

“…Camrelizumab (SHR-1210) is an anti-PD-1 antibody, which in combination with Apatinib, a TKI, has been reported at the ASCO 2018 meeting in a phase I trial with 18 HCC patients to demonstrate a response rate of 38.9% and a median progression free survival of 7.2 months (NCT02942329) [60] .…”

<p>Clinical Value Of Apatinib As A Salvage Treatment In Patients With Chemo-Refractory Advanced Cervical Cancer</p>

“…14 Several papers indicated that apatinib was an appropriate choice for chemo-refractory malignancies. [15][16][17] Although some papers have demonstrated that apatinib was effective and safe for advanced or metastatic gastric cancer, breast cancer, ovarian cancer, lung cancer, and liver cancer, 13,14,[18][19][20][21][22] doubts still exist about whether it is an appropriate choice for patients with advanced cervical cancer. Therefore, the aim of this retrospective study was to assess the efficacy and safety of apatinib in advanced cervical cancer patients with ≥2 lines of chemotherapy failure.…”