Traditional Chinese and Western Oncology Department, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Department of Oncology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China.
Pharmazie. 2020 Aug 1;75(8):389-394. doi: 10.1691/ph.2020.0403.
This study aimed to compare the therapeutic effects between apatinib combined chemotherapy and chemotherapy alone as second-line or above therapy in advanced gastric cancer (GC) or adenocarcinoma of the gastroesophageal junction (AGEJ). The clinical data of advanced GC or AGEJ patients, including sex, age, Eastern Cooperative Oncology Group (ECOG) grading, chemotherapy regimen, pathological grading, location of primary lesion, previous gastrectomy, metastases, previous chemotherapy or radiotherapy were retrospectively collected, and the progression-free survival (PFS) was recorded. 127 patients underwent apatinib combined chemotherapy and 60 patients underwent chemotherapy regimen alone. Disease control rate (DCR) of patients with apatinib combined chemotherapy was higher than that of chemotherapy alone (P=0.033). A Kaplan-Meier (KM) plot showed that PFS was significantly longer in patients receiving apatinib combined chemotherapy than those treated by chemotherapy alone (P = 0.002). The PFS of patients with a number of metastatic lesions ≤ 2 was obviously longer than that of patients with a number of metastatic lesions > 2 (P < 0.001). Cox regression analysis revealed that PFS was independently associated with the number of metastatic lesions >2 (HR=2.129, 95% CI: 1.256-3.608, P=0.005) and treatment methods (chemotherapy alone or apatinib combined chemotherapy) (HR=1.427, 95% CI: 1.055-1.930, P=0.021). Compared with chemotherapy alone, apatinib combined chemotherapy could significantly improve DCR and prolong the PFS in advanced GC or AGEJ cases who had failed in at least first-line chemotherapy with acceptable tolerance.
本研究旨在比较阿帕替尼联合化疗与单纯化疗作为二线或以上治疗晚期胃癌（GC）或胃食管结合部腺癌（AGEJ）的疗效。回顾性收集晚期 GC 或 AGEJ 患者的临床资料，包括性别、年龄、东部肿瘤协作组（ECOG）分级、化疗方案、病理分级、原发病灶位置、既往胃切除术、转移情况、既往化疗或放疗情况，并记录无进展生存期（PFS）。127 例患者接受阿帕替尼联合化疗，60 例患者接受单纯化疗方案。阿帕替尼联合化疗组患者的疾病控制率（DCR）高于单纯化疗组（P=0.033）。Kaplan-Meier（KM）图显示，接受阿帕替尼联合化疗的患者 PFS 明显长于单纯化疗组（P=0.002）。转移灶≤2 个的患者 PFS 明显长于转移灶>2 个的患者（P<0.001）。Cox 回归分析显示，PFS 与转移灶>2 个（HR=2.129，95%CI：1.256-3.608，P=0.005）和治疗方法（单纯化疗或阿帕替尼联合化疗）（HR=1.427，95%CI：1.055-1.930，P=0.021）独立相关。与单纯化疗相比，阿帕替尼联合化疗可显著提高晚期 GC 或 AGEJ 患者的 DCR，并延长至少一线化疗失败患者的 PFS，且耐受性可接受。
