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Apatinib combined with S-1 as second-line therapy in advanced gastric cancer
Advanced gastric cancer (AGC) patients are not tolerant to the toxicities of traditional chemotherapy and its second-line therapeutic regimens are limited. The aim of the present study is to evaluate the efficacy and safety of apatinib combined with S-1 as the second-line therapy for AGC patients. P...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084084/ https://www.ncbi.nlm.nih.gov/pubmed/33907117 http://dx.doi.org/10.1097/MD.0000000000025630 |
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author | Qiu, Zhi-Yuan Qin, Rong Tian, Guang-Yu Zhang, Zhao Chen, Meifang He, Han Xi, Yan Wang, Yan |
author_facet | Qiu, Zhi-Yuan Qin, Rong Tian, Guang-Yu Zhang, Zhao Chen, Meifang He, Han Xi, Yan Wang, Yan |
author_sort | Qiu, Zhi-Yuan |
collection | PubMed |
description | Advanced gastric cancer (AGC) patients are not tolerant to the toxicities of traditional chemotherapy and its second-line therapeutic regimens are limited. The aim of the present study is to evaluate the efficacy and safety of apatinib combined with S-1 as the second-line therapy for AGC patients. Patients with AGC were enrolled in this study. Patients received oral apatinib (250 mg to 500 mg once daily) and S-1(40 mg/m(2) twice daily) on days 1–14. Each cycle was 28 days and one course of treatment consisted of 2 cycles. Clinical efficacy and adverse events (AEs) were observed. Kaplan–Meier method was used for survival analysis. From November 2015 to December 2017, 58 AGC patients who failed first-line chemotherapy were enrolled and assessed retrospectively. According to the Response Evaluation Criteria in Solid Tumors (RECIST) standard, all patients were evaluable for response. None achieved CR, and 10 (17.2%) achieved PR (95% CI 7.2%–27.3%). SD was observed in 58.6% (34/58) of patients (95% CI 45.6%–71.7%) and NR in 24.1% (14/58) of patients (95% CI 12.8%–35.5%). The objective response rate (ORR) and the disease control rate (DCR) were 17.2% and 75.8% respectively. The median progression-free survival (PFS) and median overall survival (OS) were 143.1 days (95% CI 121.7–164.5) and 211.6 days (95% CI 162.9–219.7) respectively. The multivariate analysis showed that the ECOG PS was the independent factor of PFS and OS for AGC patients (PFS: HR = 3.565, 95% CI: 2.25–5.65, P < .001; OS: HR = 3.676, 95% CI: 2.29–5.89, P < .001). The main AEs were fatigue (72.4%), hypertension (46.6%), and leukopenia (48.3%). Apatinib combined with S-1 showed promising efficiency and was well tolerated as the second-line therapy for AGC patients. ECOG PS was the independent factor of PFS and OS for AGC patients. AEs were moderate and controllable, and leukopenia or hypertension was predictable factors for the PFS and OS of AGC patients. |
format | Online Article Text |
id | pubmed-8084084 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-80840842021-05-01 Apatinib combined with S-1 as second-line therapy in advanced gastric cancer Qiu, Zhi-Yuan Qin, Rong Tian, Guang-Yu Zhang, Zhao Chen, Meifang He, Han Xi, Yan Wang, Yan Medicine (Baltimore) 5700 Advanced gastric cancer (AGC) patients are not tolerant to the toxicities of traditional chemotherapy and its second-line therapeutic regimens are limited. The aim of the present study is to evaluate the efficacy and safety of apatinib combined with S-1 as the second-line therapy for AGC patients. Patients with AGC were enrolled in this study. Patients received oral apatinib (250 mg to 500 mg once daily) and S-1(40 mg/m(2) twice daily) on days 1–14. Each cycle was 28 days and one course of treatment consisted of 2 cycles. Clinical efficacy and adverse events (AEs) were observed. Kaplan–Meier method was used for survival analysis. From November 2015 to December 2017, 58 AGC patients who failed first-line chemotherapy were enrolled and assessed retrospectively. According to the Response Evaluation Criteria in Solid Tumors (RECIST) standard, all patients were evaluable for response. None achieved CR, and 10 (17.2%) achieved PR (95% CI 7.2%–27.3%). SD was observed in 58.6% (34/58) of patients (95% CI 45.6%–71.7%) and NR in 24.1% (14/58) of patients (95% CI 12.8%–35.5%). The objective response rate (ORR) and the disease control rate (DCR) were 17.2% and 75.8% respectively. The median progression-free survival (PFS) and median overall survival (OS) were 143.1 days (95% CI 121.7–164.5) and 211.6 days (95% CI 162.9–219.7) respectively. The multivariate analysis showed that the ECOG PS was the independent factor of PFS and OS for AGC patients (PFS: HR = 3.565, 95% CI: 2.25–5.65, P < .001; OS: HR = 3.676, 95% CI: 2.29–5.89, P < .001). The main AEs were fatigue (72.4%), hypertension (46.6%), and leukopenia (48.3%). Apatinib combined with S-1 showed promising efficiency and was well tolerated as the second-line therapy for AGC patients. ECOG PS was the independent factor of PFS and OS for AGC patients. AEs were moderate and controllable, and leukopenia or hypertension was predictable factors for the PFS and OS of AGC patients. Lippincott Williams & Wilkins 2021-04-30 /pmc/articles/PMC8084084/ /pubmed/33907117 http://dx.doi.org/10.1097/MD.0000000000025630 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 5700 Qiu, Zhi-Yuan Qin, Rong Tian, Guang-Yu Zhang, Zhao Chen, Meifang He, Han Xi, Yan Wang, Yan Apatinib combined with S-1 as second-line therapy in advanced gastric cancer |
title | Apatinib combined with S-1 as second-line therapy in advanced gastric cancer |
title_full | Apatinib combined with S-1 as second-line therapy in advanced gastric cancer |
title_fullStr | Apatinib combined with S-1 as second-line therapy in advanced gastric cancer |
title_full_unstemmed | Apatinib combined with S-1 as second-line therapy in advanced gastric cancer |
title_short | Apatinib combined with S-1 as second-line therapy in advanced gastric cancer |
title_sort | apatinib combined with s-1 as second-line therapy in advanced gastric cancer |
topic | 5700 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084084/ https://www.ncbi.nlm.nih.gov/pubmed/33907117 http://dx.doi.org/10.1097/MD.0000000000025630 |
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