J Gastric Cancer.  2022 Oct;22(4):408-417. 10.5230/jgc.2022.22.e33.

Apatinib as a Third-Line Treatment for HER2-Positive Metastatic Gastric Cancer: A Multi-Center Single-Arm Cohort Study

• Zhang X
• Huo H
• Nie Y
• Xue J
• Yuan Z
• Zhang Z

• KMID: 2535107
• DOI: http://doi.org/10.5230/jgc.2022.22.e33

Abstract

Purpose
Treatment options are limited after the failure of first-and second-line treatments in patients with HER2⁺ metastatic gastric cancer (mGC). The present study aimed to explore the efficacy, safety, and prognostic factors of apatinib efficacy as a third-line therapy for patients with human epithelial growth factor receptor 2-positive (HER2⁺ ) mGC.
Materials and Methods
A total of 59 HER2⁺ mGC patients who received apatinib as thirdline therapy were retrospectively enrolled in this two-center, single-arm, cohort study; the clinical response, survival data, and adverse events were retrieved.
Results
The median progression-free survival (PFS) was 5.2 months (95% confidence interval [CI], 3.9–6.5), and the median overall survival (OS) was 8.2 months (95% CI, 6.6–9.8) Furthermore, forward stepwise multivariate Cox regression analysis showed that a higher Eastern Cooperative Oncology Group performance status score and multiple metastases were independently correlated with decreased PFS and OS (both P<0.05). The main adverse events were leukopenia (45.8%), hypertension (44.1%), thrombocytopenia (39.0%), handfoot syndrome (37.3%), and elevated transaminase (33.9%). Grade 3 adverse events mainly included hypertension (5.1%) and neutropenia (5.1%); grade 4 adverse events did not occur.
Conclusions
Apatinib is efficient and well tolerated in patients with HER2⁺ mGC as a thirdline treatment, suggesting that it may be a candidate of choice for these patients.

Keyword

Apatinib; Gastric cancer; Prognosis; Mortality; Safety