Safety and efficacy analysis of low-dose apatinib in treatment of advanced malignant tumors / 肿瘤研究与临床

ABSTRACT

Objective To investigate the safety and efficacy of low-dose apatinib in treatment of advanced malignant tumors. Methods The clinical data of 54 patients with advanced malignant tumors who were admitted to Shanxi Dayi Hospital from March 2015 to March 2018 were analyzed retrospectively. These patients were treated with apatinib at doses of 250 mg (29 cases) and 500 mg (25 cases) after initial treatment or failure of multi-line treatment. There were 15 cases of gastric cancer, 11 cases of lung cancer, 9 cases of ovarian cancer, 7 cases of liver cancer, 6 cases of soft tissue sarcoma, 3 cases of esophageal cancer, 2 cases of melanoma, and 1 case of peritoneal cancer. The objective response rate (ORR), disease control rate (DCR), progress free survival (PFS) and overall survival (OS) were analyzed, and the efficacy and related adverse reactions were evaluated. Results The adverse reactions of 54 patients could be evaluated. Non-hematological drug-related adverse reactions were most common with hypertension, hand-foot skin reaction and proteinuria, while hematologic drug-related adverse reactions were most common with leukopenia and thrombocytopenia. All patients were well tolerated. The incidence of drug-related adverse reactions in the 250 mg dose group was lower than that in the 500 mg dose group, and the incidence of grade Ⅰ-Ⅱhypertension between the two groups was statistically different (χ2 = 6.268, P= 0.012). Short-term efficacyORR of the patients in the 250 mg and 500 mg dose groups was 6.9％ (2/29) and 12.0％ (3/25), respectively;DCR was 41.4％ (12/29) and 52.0％ (13/25), respectively; and the 500 mg dose group was superior to the250 mg dose group, but the differences were not statistically significant (ORR χ2= 0.416, P= 0.519; DCRχ2= 0.609, P= 0.435). Long-term efficacy the 500 mg dose group had a slight advantage over the 250 mg dose group in both median PFS time (3.9 months vs. 3.6 months) and median OS time (7.8 months vs. 7.6 months), but the differences were not statistically significant (PFSχ2=0.472, P=0.492; OSχ2=0.261, P=0.609). Conclusions Low-dose apatinib can be used to treat advanced malignant tumors. The drug-related adverse reactions are small, the curative effects are exact, the adverse reactions are easy to tolerate, and it is convenient for long-term use. Low-dose apatinib is one of the treatment options for advanced malignant tumors.