Department of Radiation Oncology, The Harbin Medical University Cancer Hospital, Harbin, 150040, China.
BMC Pharmacol Toxicol. 2019 Oct 28;20(1):61. doi: 10.1186/s40360-019-0362-2.
In recent years, targeted therapy has received widespread attention. Among these therapies, anti-angiogenic targeted drugs have become one of the hotspots of research. Apatinib is a novel oral small molecule anti-angiogenic agent that has been clinically tested in a variety of solid tumours. The aim of this study was to investigate the efficacy of apatinib in patients with advanced malignant tumours and failure of standard therapy.
We collected 41 patients with advanced malignant tumours in our department; all tumours were pathologically confirmed as malignant. All patients received apatinib after failure of standard therapy: 500 mg/dose, one dose/d, orally 30 min after a meal, until progressive disease or intolerable adverse reactions occurred. When there was a second- or third-degree adverse reaction associated with apatinib during treatment, apatinib treatment could be suspended or reduced to 250 mg/dose. Clinical efficacy and progression-free survival were assessed according to RECIST1.1, and adverse reactions were observed.
Efficacy assessment was available for 31 patients with a median progression-free survival time of 2.66 months; the objective response rate and disease control rates were 16.1 and 64.5%, respectively. The disease control rates of the patients with lower Eastern Cooperative Oncology Group scores (1-2 points) and with fewer metastatic sites (< 3 sites) were higher than those of the patients with higher scores (3 points) and with more metastatic sites (≥3 sites), respectively (all P < 0.05). The most common adverse reactions were hypertension, neutropenia and hand-foot syndrome.
For patients with advanced malignant tumours with failure of standard therapy, administration of apatinib can still result in good efficacy. The efficacy of apatinib is better in patients with a higher performance status and lower degree of tumour progression.
近年来，靶向治疗受到广泛关注。在这些疗法中，抗血管生成靶向药物已成为研究热点之一。阿帕替尼是一种新型的口服小分子抗血管生成药物，已在多种实体瘤中进行了临床研究。本研究旨在探讨阿帕替尼治疗晚期恶性肿瘤标准治疗失败患者的疗效。
我们收集了我科 41 例晚期恶性肿瘤患者，所有肿瘤均经病理证实为恶性。所有患者在标准治疗失败后接受阿帕替尼治疗：500mg/次，1 次/d，餐后 30min 口服，直至疾病进展或不能耐受不良反应。治疗过程中出现与阿帕替尼相关的 2 或 3 级不良反应时，可暂停或减少至 250mg/次。根据 RECIST1.1 评估临床疗效和无进展生存期，观察不良反应。
31 例患者可评估疗效，中位无进展生存期为 2.66 个月；客观缓解率和疾病控制率分别为 16.1%和 64.5%。Eastern Cooperative Oncology Group 评分较低（1-2 分）和转移部位较少（<3 个）的患者疾病控制率均高于评分较高（3 分）和转移部位较多（≥3 个）的患者（均 P<0.05）。最常见的不良反应为高血压、中性粒细胞减少和手足综合征。
对于标准治疗失败的晚期恶性肿瘤患者，阿帕替尼仍能取得较好疗效。在一般状况较好和肿瘤进展程度较低的患者中，阿帕替尼的疗效更好。
