Clinical effect of apatinib combined with chemotherapy for advanced gastric cancer as second-line and above treatment
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Abstract:
Objective: To observe the clinical efficacy of apatinib combined with chemotherapy for advanced gastric cancer as secondline and above treatment, and to analyze the survival of patients. Methods: Seventy-two patients with advanced gastric cancer that treated at Department of Oncology, the First Affiliated Hospital of Zhengzhou University from March 2016 to April 2017 were included in this study according to the inclusion and exclusion criteria; patients were randomly divided into chemotherapy group, apatinib group,apatinib combined with chemotherapy group. And the clinical efficacy and the survival of patients were investigated. Results: For chemotherapy group, apatinib group, apatinib combined with chemotherapy group, the disease control rate (DCR) and objective response rate (ORR) were 48.3%, 61.1%,72.0% (P>0.05) and 13.8%, 16.7%, 28.0%(P>0.05), respectively; and the incidence rate of adverse reaction at grade three-four was 17.1%, 16.8% and 24.0% (P>0.05), respectively. Compared with the chemotherapy group (93 d), the median progress-free survival (mPFS) time in the apatinib group and apatinib combined with chemotherapy group was 117 d (P=0.128) and 160 d (P=0.001). Furthermore, univariate and multivariate analyses showed that TNM staging (P=0.036), ascites (P=0.041) and treatment regimen (P=0.001) were the independent factors affecting PFS. Conclusion: As the second-line or above treatment in advanced gastric cancer, compared with single chemotherapy and single apatinib group, apatinib combined with chemotherapy displays more satisfactory achievement in remission rate, accompanied by controllable adverse reactions and considerable survival benefit.
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Project supported by the National Natural Science Foundation of China (No.81472605)