Zheng Zhuangzhuang, Liu Zijing, Zhang Haifeng, Guo Xiao, Jia Xiaojing, Wang Jianfeng, Meng Lingbin, Xin Ying, Jiang Xin
Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, China.
Jilin Provincial Key Laboratory of Radiation Oncology and Therapy, Changchun, China.
Front Pharmacol. 2022 May 17;13:894016. doi: 10.3389/fphar.2022.894016. eCollection 2022.
Apatinib is a novel antiangiogenic agent that can target vascular endothelial cell growth factor 2. The aim of our study was to evaluate the efficacy and safety of apatinib mesylate in the treatment of advanced hepatocellular carcinoma (HCC) in the real world. We retrospectively analyzed 178 patients with advanced HCC who had been treated with apatinib mesylate from January 2017 to March 2020. The primary outcome indexes were progression-free survival (PFS) and overall survival (OS), and the secondary outcome indexes were overall response rate (ORR), disease control rate (DCR), and incidence of treatment-related adverse reactions. Univariate analysis showed that patients with third-line treatment ( <0.001), alpha fetoprotein (AFP) ≥400 ng/ml ( <0.05), distant metastasis ( <0.05), portal vein tumor thrombus (PVTT) ( <0.05), and apatinib monotherapy ( <0.001) had shorter survival. Multivariate analysis confirmed that third-line drugs, PVTT, and combination therapy were independent prognostic factors for PFS in all patients. Univariate analysis showed that Eastern Cooperative Oncology Group (ECOG) scores ( <0.05), line of apatinib ( <0.001), AFP ( <0.001), tumor progression ( <0.05), PVTT ( <0.05), and combination therapy ( <0.001) may impact the OS. Multivariate analysis proved that AFP, PVTT, and combination therapy were independent prognostic factors for OS. The most common adverse reactions were secondary hypertension (29.21%), symptoms of fatigue (16.85%), hand and foot syndrome (16.29%), vomiting (14.04%), liver dysfunction (6.18%), and proteinuria (6.74%). Most of the adverse reactions were Grade 1 or 2. Apatinib mesylate is an effective treatment for advanced HCC, and its adverse reactions are relatively mild. Line of apatinib, PVTT, AFP level, and combination therapy were independent prognostic factors for patients with advanced HCC who were treated with apatinib.
阿帕替尼是一种新型抗血管生成药物，可靶向血管内皮生长因子2。我们研究的目的是评估甲磺酸阿帕替尼在现实世界中治疗晚期肝细胞癌（HCC）的疗效和安全性。我们回顾性分析了2017年1月至2020年3月期间接受甲磺酸阿帕替尼治疗的178例晚期HCC患者。主要结局指标为无进展生存期（PFS）和总生存期（OS），次要结局指标为总缓解率（ORR）、疾病控制率（DCR）以及治疗相关不良反应的发生率。单因素分析显示，接受三线治疗的患者（<0.001）、甲胎蛋白（AFP）≥400 ng/ml（<0.05）、远处转移（<0.05）、门静脉癌栓（PVTT）（<0.05）以及阿帕替尼单药治疗（<0.001）的患者生存期较短。多因素分析证实，三线治疗药物、PVTT和联合治疗是所有患者PFS的独立预后因素。单因素分析显示，东部肿瘤协作组（ECOG）评分（<0.05）、阿帕替尼治疗线数（<0.001）、AFP（<0.001）、肿瘤进展（<0.05）、PVTT（<0.05）以及联合治疗（<0.001）可能影响OS。多因素分析证明，AFP、PVTT和联合治疗是OS的独立预后因素。最常见的不良反应为继发性高血压（29.21%）、乏力症状（16.85%）、手足综合征（16.29%）、呕吐（14.04%）、肝功能不全（6.18%）和蛋白尿（6.74%）。大多数不良反应为1级或2级。甲磺酸阿帕替尼是治疗晚期HCC的有效药物，其不良反应相对较轻。阿帕替尼治疗线数、PVTT、AFP水平和联合治疗是接受阿帕替尼治疗的晚期HCC患者的独立预后因素。
