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阿帕替尼治疗晚期或转移性胃或胃食管交界腺癌患者的有效性和安全性:一项前瞻性观察研究

Effectiveness and Safety of Apatinib in Patients with Advanced or Metastatic Adenocarcinoma of Stomach or Gastroesophageal Junction: A Prospective Observation Study.

作者信息

Shen Bo, Jiang Hua, Wang Lin, Qian Jun, Shu Yongqian, Chen Ping, Mao Guoxin, Liu Baorui, Zhang Xizhi, Liu Chaoying, Wu Jun, Li Xiaoqin, Cai Wei, Shen Wenxiang, Wang Qiong, He Jingdong, Hua Dong, Zhang Ziwen, Zhang Youcheng, Feng Jifeng

机构信息

Department of Oncology, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

Department of Oncology, Changzhou No. 2 People's Hospital, Changzhou, People's Republic of China.

出版信息

Onco Targets Ther. 2020 May 20;13:4457-4464. doi: 10.2147/OTT.S232287. eCollection 2020.

Abstract

BACKGROUND

Apatinib showed promising efficacy in the treatment of advanced or metastatic gastric cancer (mGC) in previous clinical studies. However, the real-world data are limited, and this study aimed to assess the effectiveness and safety of apatinib for the treatment of advanced or mGC in this setting.

METHODS

In this prospective observational study, progression-free survival (PFS), overall survival (OS), overall response rate (ORR), disease control rate (DCR) and treatment-related adverse events (AEs) were recorded and evaluated. Univariate and multivariate analyses were conducted to explore potential biomarkers which might be related to the effectiveness.

RESULTS

A total of 321 mGC patients from 47 centers in China were enrolled between July 1, 2015, and March 1, 2018. Thirty-two patients achieved partial response, 155 patients achieved stable disease, and 115 patients had progressive disease, and no CR was achieved, illustrating an ORR of 10.60% and a DCR of 61.92%. The median PFS and OS were 4.0 and 8.2 months, respectively. Multivariate Cox analysis showed that the potential biomarkers associated with longer PFS were combination regimens plus taxel/docetaxel, and apatinib initial dosage ≥500mg, occurrence of AEs of leukopenia, and hand-foot syndrome. Main AEs were proteinuria (17.1%), hypertension (15.9%), and handfoot syndrome (8.7%).

CONCLUSION

The present prospective observational study showed favorable effectiveness and safety of apatinib in real-world patients with advanced or metastatic GC in China. (A prospective, multi-center, non-intervention study of apatinib in the treatment of advanced gastric cancer-Trial Registry Number: ChiCTR-OPN-15006601).

摘要

背景

在先前的临床研究中,阿帕替尼在晚期或转移性胃癌(mGC)治疗中显示出有前景的疗效。然而,真实世界数据有限,本研究旨在评估阿帕替尼在此情况下治疗晚期或mGC的有效性和安全性。

方法

在这项前瞻性观察性研究中,记录并评估无进展生存期(PFS)、总生存期(OS)、总缓解率(ORR)、疾病控制率(DCR)以及治疗相关不良事件(AE)。进行单因素和多因素分析以探索可能与有效性相关的潜在生物标志物。

结果

2015年7月1日至2018年3月1日期间,中国47个中心共纳入321例mGC患者。32例患者达到部分缓解,155例患者病情稳定,115例患者疾病进展,未达到完全缓解,ORR为10.60%,DCR为61.92%。中位PFS和OS分别为4.0个月和8.2个月。多因素Cox分析显示,与更长PFS相关的潜在生物标志物为联合方案加紫杉醇/多西他赛、阿帕替尼初始剂量≥500mg、白细胞减少症AE的发生以及手足综合征。主要AE为蛋白尿(17.1%)、高血压(15.9%)和手足综合征(8.7%)。

结论

本前瞻性观察性研究表明,阿帕替尼在中国晚期或转移性GC真实世界患者中具有良好的有效性和安全性。(阿帕替尼治疗晚期胃癌的前瞻性、多中心、非干预性研究 - 试验注册号:ChiCTR-OPN-15006601)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1068/7246318/ef37756a3584/OTT-13-4457-g0001.jpg

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