Wang Zhenfeng, He Tingbang, Yu Deguo, Qin Xiantao, Geng Aizhi, Yang Hailei
Department of General Surgery, The Second People's Hospital of Liaocheng, Linqing, Liaocheng, Shandong 252699, P.R. China.
Department of General Surgery, The People's Hospital of Xiajin Affiliated to Shandong First Medical University, Xiajin, Dezhou, Shandong 253299, P.R. China.
Exp Ther Med. 2022 Aug 17;24(4):625. doi: 10.3892/etm.2022.11562. eCollection 2022 Oct.
The current study aimed to evaluate the efficacy and safety of neoadjuvant apatinib plus tegafur/gimeracil/oteracil potassium (S-1) plus oxaliplatin (SOX) chemotherapy in patients with locally advanced gastric carcinoma (LAGC). Therefore, patients with LAGC treated with neoadjuvant apatinib plus SOX chemotherapy (apatinib + SOX group; n=25) or SOX chemotherapy (SOX group; n=35) were enrolled in the present study. Subsequently, the objective response (ORR) and disease control rates (DCR), pathological response, disease-free survival (DFS), overall survival (OS) and adverse events were recorded. The results showed that patients in the apatinib + SOX group exhibited a higher ORR (64.0 vs. 37.1%; P=0.040), but a similar DCR (96.0 vs. 88.6%; P=0.580), compared with those in the SOX group. The pathological response rates in patients with grade 0, 1, 2 and 3 LAGC were 0.0, 20.8, 62.5 and 16.7%, respectively, in the apatinib + SOX group, while in those treated with SOX alone they were 9.1, 39.4, 42.4 and 9.1%, respectively. By contrast, the pathological response was elevated in the apatinib + SOX group compared with the SOX group (P=0.030). During a median follow-up period of 21.0 months (range, 6.4-38.1 months), median DFS and OS were not reached. More specifically, the 1-, 2- and 3-year DFS rates were 91.7, 75.2 and 75.2% in the apatinib + SOX group and 71.8, 59.6 and 44.7% in the SOX group, respectively. In addition, the 1-, 2- and 3-year OS rates were 100.0, 89.6 and 78.4% in the apatinib + SOX group, while those in the SOX group were 90.3, 69.2 and 55.4%, respectively. However, no differences in DFS (P=0.094) or OS (P=0.155) were observed between the two groups. Additionally, the most common adverse events in the SOX group were mild leukopenia (42.9%) and fatigue (34.3%), while those in the apatinib + SOX group were tolerable leukopenia (44.0%) and hypertension (44.0%). In conclusion, the present study suggested that neoadjuvant apatinib plus SOX chemotherapy could be more effective and tolerable compared with SOX chemotherapy alone in patients with LAGC.
本研究旨在评估新辅助阿帕替尼联合替吉奥（S-1）及奥沙利铂（SOX）化疗方案在局部进展期胃癌（LAGC）患者中的疗效及安全性。因此，本研究纳入了接受新辅助阿帕替尼联合SOX化疗的LAGC患者（阿帕替尼+SOX组；n=25）以及接受SOX化疗的患者（SOX组；n=35）。随后，记录客观缓解率（ORR）、疾病控制率（DCR）、病理反应、无病生存期（DFS）、总生存期（OS）及不良事件。结果显示，与SOX组相比，阿帕替尼+SOX组患者的ORR更高（64.0%对37.1%；P=0.040），但DCR相似（96.0%对88.6%；P=0.580）。在阿帕替尼+SOX组中，0、1、2和3级LAGC患者的病理反应率分别为0.0%、20.8%、62.5%和16.7%，而在单纯接受SOX治疗的患者中，上述病理反应率分别为9.1%、39.4%、42.4%和9.1%。相比之下，阿帕替尼+SOX组的病理反应高于SOX组（P=0.030）。在中位随访期21.0个月（范围6.4 - 38.1个月）内，未达到中位DFS和OS。更具体地说，阿帕替尼+SOX组的1年、2年和3年DFS率分别为91.7%、75.2%和75.2%，SOX组分别为71.8%、59.6%和44.7%。此外，阿帕替尼+SOX组的1年、2年和3年OS率分别为100.0%、89.6%和78.4%，SOX组分别为90.3%、69.2%和55.4%。然而，两组之间在DFS（P=0.094）或OS（P=0.155）方面未观察到差异。此外，SOX组最常见的不良事件为轻度白细胞减少（42.9%）和疲劳（34.3%），而阿帕替尼+SOX组为可耐受的白细胞减少（44.0%）和高血压（44.0%）。总之，本研究表明，对于LAGC患者，新辅助阿帕替尼联合SOX化疗比单纯SOX化疗更有效且耐受性更好。
