Retrospective study of conversion therapy using two-drug combination chemotherapy with apatinib for unresectable stage gastric cancer
10.3969/j.issn.1000-8179.2020.09.692
- VernacularTitle: 联合应用阿帕替尼在不可切除晚期胃癌转化治疗中的研究*
- Author:
Mingzhi CAI
1
Author Information
1. Department of Gastroenterological Cancer Surgery, Tianjin Medical University Cancer institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, TianJin's Clinical Research Center for Cancer
- Publication Type:Journal Article
- From:
Chinese Journal of Clinical Oncology
2020;47(9):446-449
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the safety and efficacy of fluorouracil-based two-drug combination chemotherapy with apatinib, as a conversion therapy, in patients with unresectable gastric cancer (GC). Methods: A retrospective analysis of 33 patients with unresectable stage IV GC receiving conversion therapy at Tianjin Medical University Cancer Institute and Hospital between March 2017 and June 2018, was performed. Patients with peritoneal or ovarian metastasis received S1/paclitaxel (PTX)/apatinib (S1: 60 mg, bid, days 1-14; PTX: 50 mg/m2 iv, days 1 and 8; PTX: 20 mg/m2 ip, days 1 and 8; q3w; apatinib 500 mg po, qd). Patients with other non-curable factors were administered a regimen of SOX plus apatinib (oxaliplatin 130 mg/m2, S1: 60 mg, bid, days 1-14; apatinib 500 mg po, qd). Apatinib should be withdrawn from the last cycle before surgery. Surgery should be performed after MDT. Results: After at least three cycles chemotherapy, 21 patients achieved partial response (PRand 8 patients had progressive disease (PD), resulting in an objective response rate of 75.7%. Surgery was performed on 22 patients with PR, and 21 patients (63.6%) achieved R0 resection; the number of excised lymph nodes was 57.0±15.6, intraoperative hemorrhage was (164±46) mL, the operation time was (212.0±44.8) min, and the postoperative hospital stay was (13.0±2.7) days. Patients who had surgery had a median progression free survival (mPFS) of 10.5 months and an median overall survival (mOSof 16.5 months; for patients who did not undergo surgery, the median progression free survival (mPFSwas 2.5 months and mOS was 5.5 months. Conclusions: As a conversion therapy, fluorouracil-based two drug-combination chemotherapy with apatinib provided a high R0 resection rate for unresectable stage GC, with an acceptable safety profile. Keywords: apatinib, gastric cancer (GC), conversion therapy, safety, efficacy
