Randomized, Double-Blind, Placebo-Controlled Phase III Trial of Apatinib in Patients With Chemotherapy-Refractory Advanced or Metastatic Adenocarcinoma of the Stomach or Gastroesophageal Junction

Li, Jin; Qin, Shukui; Xu, Jianming; Xiong, Jianping; Wu, Changping; Bai, Yuxian; Liu, Wei; Tong, Jie; Liu, Yunpeng; Xu, Rui‐hua; Wang, Zhehai; Wang, Qiong; Ouyang, Xin; Yang, Yan; Ba, Yi; Liang, Jun; Lin, Xinhua; Luo, Dan; Zheng, Rongqin; Wang, Xin; Sun, Guoping; Wang, Liwei; Zheng, Leizhen; Guo, Hong; Wu, Jingbo; Xu, Nong; Yang, Jun; Zhang, Honggang; Cheng, Ying; Wang, Ningju; Chen, Lei; Fan, Zhining; Sun, Piaoyang; Yu, Hao

doi:10.1200/jco.2015.63.5995

Cited by 769 publications

(829 citation statements)

References 19 publications

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“…More recently, a double-blind randomized study evaluated the activity of apatinib (another VEGFR2-inhibitor) in 267 heavily pretreated patients with advanced GACs. The study reported a modest but statistically significant improvement in progression free survival and overall survival in apatinib treated patients compared to placebo [85]. Taken together, these trials demonstrate that antiangiogenic drugs could be relevant in the treatment of advanced gastric cancer.…”

Section: Treatment Response and Disease Outcomes In Gacsmentioning

confidence: 74%

Genomics and epidemiology for gastric adenocarcinomas

2017

Appl Cancer Res

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Whereas the pathological aspects of Gastric Adenocarcinomas (GACs) have been well defined, the actual knowledge of its genesis and evolution remains to be translated to better diagnosis and to more effective therapeutics. As a consequence, the current treatment modalities are not yet able to modify the natural history of the disease, which still presents high mortality-rates worldwide. In this review we highlight the current status of relevant epidemiologic, therapeutic and genomics aspects of GACs and point to some of the current knowledge gaps that, if fully addressed, could contribute to a more effective treatment and better management of the patients that suffer from this often-lethal disease.

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Section: Treatment Response and Disease Outcomes In Gacsmentioning

confidence: 74%

Genomics and epidemiology for gastric adenocarcinomas

2017

Appl Cancer Res

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“…The benefits exhibited by the RFGEV-2 inhibitor, ramucirumab, and the VEGFR-2 tyrosine kinase inhibitor, apatinib, represent an advance in the development of antiangiogenic drugs for metastatic GC 27,28 . Future trials should investigate ramucirumab given as first-line therapy in combination with other chemotherapeutic agents, or with a specific molecular determination.…”

Section: Discussionmentioning

confidence: 99%

Real-world evidence: A review of clinical experience in metastatic gastric cancer second-line treatment with ramucirumab

Quintana-Quintana¹,

Díaz-Romero²,

Camacho-Limas³

et al. 2022

GAMO

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An improvement in overall survival of patients with gastrointestinal tumors has been observed in recent years, with main factors for this being an in-depth understanding of molecular biology, determination of prognostic factors, and of course, the development of new drugs, all of which has allowed gradual but significant advances in the treatment of gastric cancer. First-line treatment has shown benefits; however, many of these patients show disease progression, which raises the challenge of optimizing the ensuing treatment lines and developing better treatment strategies. The role of second-line treatment has recently been introduced and discussed, although there is evidence regarding the benefit of some drugs such as docetaxel, paclitaxel and irinotecan in second-line treatment, with this benefit having shown a reduction of approximately 18% in the risk of death, there is still a need to discuss and analyze efficacy in overall survival, progression-free survival and toxicity profile, with a special emphasis on the appropriate choice of drugs according to efficacy, toxicity, prognostic factors, and patient characteristics. The objective of this cross-sectional study is

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“…The drug has also shown moderate OS beneits when used in combination with docetaxel for second-line treatment of stage IV NNSCLS compared with docetaxel alone after progression on platinum-based chemotherapy (10.5 months vs. 9.1 months, ramucirumab plus docetaxel vs. docetaxel alone, respectively) [112]. Apatinib is another novel VEGFR-2 inhibitor, a small molecule not yet given FDA approval (although it is approved for use in China in treating metastatic gastric or gastroesophageal adenocarcinoma after second-line chemotherapy) [113]. The drug thus far has shown only moderate survival beneits of 1.8 months, and several trials are ongoing to assess its eicacy in diferent setings [114].…”

Section: Treatment Methodsologies and New Treatmentsmentioning

confidence: 99%

Anti-VEGF Therapy in Cancer: A Double-Edged Sword

Gardner¹,

Madu²,

Lü³

2017

Physiologic and Pathologic Angiogenesis - Signaling Mechanisms and Targeted Therapy

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Vascular endothelial growth factor (VEGF) is a mitogen that plays a crucial role in angiogenesis and lymphangiogenesis. It is involved in tumor survival through inducing tumor angiogenesis and by increasing chemoresistance through autocrine signaling. Because of its importance in tumor formation and survival, several medications have been developed to inhibit VEGF and reduce blood vessel formation in cancer. Although these medications have proven to be efective for late-stage and metastatic cancers, they have been shown to cause side efects such as hypertension, artery clots, complications in wound healing, and, more rarely, gastrointestinal perforation and istulas. Current research in using anti-VEGF medication as a part of cancer treatments is focusing on elucidating the mechanisms of tumor resistance to VEGF medication, developing predictive biomarkers that assess whether a patient will respond to VEGF therapy and creating novel treatments and techniques that increase the eicacy of antiangiogenic medication. This chapter aims to review the role of VEGF in tumor angiogenesis and metastasis, the structure and function of VEGF and its receptors, and VEGF's role in cancer are discussed. Furthermore, tumor therapies targeting VEGF along with their side efects are presented and, inally, new directions in anti-VEGF therapy are considered along with the challenges.

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Randomized, Double-Blind, Placebo-Controlled Phase III Trial of Apatinib in Patients With Chemotherapy-Refractory Advanced or Metastatic Adenocarcinoma of the Stomach or Gastroesophageal Junction

Abstract: These data show that apatinib treatment significantly improved OS and PFS with an acceptable safety profile in patients with advanced gastric cancer refractory to two or more lines of prior chemotherapy.

Cited by 769 publications

References 19 publications

Genomics and epidemiology for gastric adenocarcinomas

Genomics and epidemiology for gastric adenocarcinomas

Real-world evidence: A review of clinical experience in metastatic gastric cancer second-line treatment with ramucirumab

Anti-VEGF Therapy in Cancer: A Double-Edged Sword

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