Expert Consensus on the Treatment of Antiangiogenic Agents for Radiation Brain Necrosis / 中国肺癌杂志

Vascular damage is followed by vascular endothelial growth factor (VEGF) expression at high levels, which is an important mechanism for cerebral radiation necrosis (CRN) development. Antiangiogenic agents (Bevacizumab) alleviates brain edema symptoms caused by CRN through inhibiting VEGF and acting on vascular tissue around the brain necrosis area. Many studies have confirmed that Bevacizumab effectively relieves symptoms caused by brain necrosis, improves patients' performance status and brain necrosis imaging. Considering that the efficacy of antiangiogenic therapy is mainly related to the duration of drug action, low-dose antiangiogenic agents can achieve favorable efficacy. Prevention is the best treatment. The occurrence of CRN is associated with tumor-related factors and treatment-related factors. By controlling these factors, CRN can be effectively prevented.
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Research Progress of Fruquintinib on Advanced Colorectal Cancer / 肿瘤防治研究

Fruquintinib is an effective, highly selective and oral VEGFR 1, 2 and 3 tyrosine kinase inhibitor. It was discovered and developed by Hutchison MediPharma for the treatment of solid tumors. In September 2018, fruquintinib received its first global approval in China for use in the treatment of metastatic colorectal cancer (CRC) patients who have failed at least two prior systemic anti-neoplastic therapies. Clinical studies have shown that it has the advantages of low off-target toxicity, good drug resistance and strong curative effect. This article reviews the molecular structure, mechanism of action, pharmacokinetics, clinical efficacy and safety of fruquintinib, as well as its potential clinical applications in other tumor types.

Progress of Antiangiogenic Drug-induced Renal Injury / 肿瘤防治研究

With the continuous development of precision targeting medicine, antiangiogenic drugs have achieved good therapeutic effects in the treatment of advanced cancer, but renal injury and other adverse reactions often occur during the use, which reduce the quality of life of patients. This article reviews the mechanism of renal injury induced by antiangiogenic drugs and the potential relation between renal injury and prognosis.

Research Progress on Antitumor Mechanism of Apatinib / 肿瘤防治研究

In recent years, antiangiogenic drugs based on VEGF and VEGFRs signaling pathway have been widely used in the treatment of malignant tumors. Apatinib is an orally bioavailable small-molecule antiangiogenic agent and can specifically inhibit the tyrosine kinase activity of VEGFR, thereby inhibiting tumor angiogenesis. Apatinib is the first-level recommendation of third-line treatment of gastric cancer in CSCO Guidelines for the Diagnosis and Treatment of Gastric Cancer published in 2018. Apatinib has been proved to be effective and safe in gastric, lung and breast cancers. In addition, the drug shows great potential in the treatment of a variety of solid tumors. This article reviews the recent progress on the mechanism, clinical efficacy, related efficacy predictors of apatinib and its combination with other antitumor drugs.

Apatinib combined with capecitabine in the treatment of advanced triple-negative breast cancer as third-line therapy: An observational study / 中国临床药理学与治疗学

AIM: To investigate the efficacy and safety of apatinib combined with capecitabine in the treatment of advanced triple-negative breast cancer (TNBC) as third-line therapy. METHODS: Sixty advanced TNBC patients, who have failed to receive second-line palliative chemotherapy, were enrolled in the Department of Oncology, Anqing Hospital Affiliated to Anhui Medical University from February 2016 to September 2019. Patients were divided into observation group (n=30, received apatinib combined with capecitabine) and control group (n=30, received capecitabine) randomly. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), 1-year survival rate, overall survival (OS) and adverse events between the two groups were observed and compared. RESULTS:ORR was 26.67% and DCR was 86.67% in the observation group, while 6.67% and 60.00% in the control group, respectively. ORR and DCR in the observation group were better than those in the control group (P=0.038; 0.020). Meanwhile, the median PFS was 7.0 months in the observation group, while it was 5.0 months in the control group, which indicated that the observation group exhibited a higher PFS than the control group (P=0.000). The 1-year survival rate and the median OS was 55.30% and 13.0 months in the observation group respectively, while those were 46.30% and 12.0 months in the control group respectively, the OS showed no significant differences between the two groups (P=0.258). In addition, we also found that there was significant differences in the adverse reaction such as hypertension between the two groups (P=0.000), yet it was mild and tolerable after symptomatic treatment. CONCLUSION:Apatinib combined with capecitabine in the advanced TNBC maintenance treatment has a certain survival benefit for those who failed in second-line therapy, and adverse reactions are tolerable and controllable.

Advances in antiangiogenic drug-induced hypertension / 中国肿瘤临床

Antiangiogenic therapy is an essential approach in the treatment of malignant tumors along with the development of preci-sion medicine. However, the occurrence of antiangiogenic therapy-induced hypertension, which is the most common toxicity of this agent, influences its broad clinical use (in some cases). Researches on its mechanisms, prevention, and management, have been con-ducted, but clinical guidelines or expert consensuses have not been reached. In this review, we presented the epidemiology, current re-search status, and systematic management of antiangiogenic therapy-induced hypertension.

Tratamiento de la neovascularización coroidea miópica / Treatment of myopic choroidal neovascularization

Se realizó una revisión sobre el tratamiento de la neovascularización coroidea en la miopía degenerativa. Se consultaron fundamentalmente artículos científicos de revistas publicados e indexados en las bases de datos PubMED y Cochrane, así como textos básicos que abordan este tema. No se encontraron certezas del beneficio de la fotocoagulación con láser de las lesiones neovasculares en esta entidad, mientras que la terapia fotodinámica parece brindar estabilidad de la lesión y mejoría visual, al menos a los 3 años de seguimiento. El uso de antiangiogénicos intravítreos tiene los mejores resultados en la actualidad respecto a la inactivación de la lesión y la recuperación visual pero no hay ensayos clínicos controlados que avalen su beneficio a largo plazo. Otras opciones de tratamiento se encuentran en investigación y desarrollo. No se ha concebido el protocolo ideal para tratar las membranas neovasculares miópicas

A literature review on the treatment of the choroidal neovascularization in the degenerative myopia was made. Published scientific articles of journals indexed in Pubmed and Cochrane databases, as well as basic texts that deal with this topic. No evidences of the benefits of the laser photocoagulation for neovascular lesions were found, whereas the photodynamic therapy seems to offer stability of the lesion and visual improvement after three years of follow-up. The use of intravitreous antiangiogenic drugs has currently achieved the best results in terms of lesion inactivation and visual recovery, but there are no controlled clinical trials that support their long-term benefits. Other treatment options are under research and development. The ideal protocol of treatment of neovascular myopic membranes has not yet been devised

The effect of subconjunctival bevacizumab on corneal neovascularization, inflammation and re-epithelization in a rabbit model

PURPOSE: To evaluate the use of subconjunctival bevacizumab on corneal neovascularization in an experimental rabbit model for its effect on vessel extension, inflammation, and corneal epithelialization. METHODS: In this prospective, randomized, blinded, experimental study, 20 rabbits were submitted to a chemical trauma with sodium hydroxide and subsequently divided into two groups. The experimental group received a subconjunctival injection of bevacizumab (0.15 m; 3.75 mg), and the control group received an injection of 0.15 ml saline solution. After 14 days, two blinded digital photograph analyses were conducted to evaluate the inflammation/diameter of the vessels according to pre-established criteria. A histopathological analysis of the cornea evaluated the state of the epithelium and the number of polymorphonuclear cells. RESULTS: A concordance analysis using Kappa's statistic showed a satisfactory level of agreement between the two blinded digital photography analyses. The neovascular vessel length was greater in the control group (p<0.01) than in the study group. However, the histopathological examination revealed no statistically significant differences between the groups in terms of the state of the epithelium and the number of polymorphonuclear cells. CONCLUSIONS: Subconjunctival bevacizumab inhibited neovascularization in the rabbit cornea. However, this drug was not effective at reducing inflammation. The drug did not induce persistent corneal epithelial defects.