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Safety and effectiveness of apatinib in patients with previously treated metastatic gastric cancer: a sub-analysis from the real-world study of apatinib for gastric cancer treatment (AHEAD-G202).

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机构： [1]Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing 100032, China. [2]Department of Oncology, Peace Hospital of Changzhi Medical College Changzhi 046000, China. [3]Digestive Department of Oncology, Shanxi Tumor Hospital Taiyuan 030013, China. [4]Oncology Department, Shanxi Provincial Hospital of Traditional Chinese Medicine Taiyuan 030012, China. [5]Department of Medical Oncology, Cangzhou Central Hospital Cangzhou 061000, China. [6]Oncology Department, Yangquan First People's Hospital Yangquan 045000, China. [7]Department of Gastroenterology, The Fourth Hospital of Hebei Medical University Shijiazhuang 050071, China. [8]Department of Medical Oncology, Tianjin Medical University General Hospital Tianjin 300052, China. [9]Department of Medical Oncology, Fourth Medical Center of PLA General Hospital Beijing 100048, China. [10]Department of Medical Oncology, First Hospital of Qinhuangdao Qinhuangdao 066001, China. [11]Department of Medical Oncology, First Hospital of Shanxi Medical University Taiyuan 030001, China. [12]Department of Medical Oncology, Affiliated Hospital of Chengde Medical University Chengde 067000, China. [13]Department of Medical Oncology, Datong Second People's Hospital Datong 037005, China. [14]Department of Medical Oncology, Shanxi Academy of Medical Sciences, Shanxi Dayi Hospital Taiyuan 030032, China. [15]Department of Medical Oncology, Xingtai People's Hospital, Hebei Medical University Affiliated Hospital Xingtai 054031, China. [16]Department of Medical Oncology, Chinese PLA General Hospital, Medical School of Chinese PLA Beijing 100039, China. [17]Department of Medical Oncology, Second Hospital of Shanxi Medical University Taiyuan 030001, China. [18]Department of Medical Oncology, Shijiazhuang People's Hospital Shijiazhuang 050011, China. [19]Department of Medical Oncology, Seventh Medical Center of PLA General Hospital Beijing 100700, China. [20]Department of Tumor Chemotherapy and Radiology, Peking University Third Hospital Beijing 100191, China. [21]Department of Medical Oncology, Air Force General Hospital, PLA Beijing 100142, China. [22]Department of Radiology, Handan Central Hospital Handan 056001, China. [23]Department of Medical Oncology, Peking University Binhai Hospital Tianjin 300450, China. [24]Department of General Surgery, Fifth Medical Center of PLA General Hospital Beijing 100071, China. [25]Department of Medical Oncology, Tianjin People's Hospital Tianjin 30000, China. [26]Department of Hematology and Oncology, Strategic Support Force Characteristic Medical Center/Former The 306 Hospital of PLA Beijing 100101, China. [27]Department of Medical Oncology, Sixth Medical Center of PLA General Hospital Beijing 100048, China. [28]Department of Medical Oncology, Affiliated Hospital of Hebei University Baoding 071000, China. [29]Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital Tianjin 300060, China.

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Apatinib, a VEGFR2 receptor tyrosine kinase inhibitor, showed survival benefits in Asian patients with heavily pretreated advanced gastric cancer. However, the adverse event (AEs) profile of apatinib has limited its use. Dosing schedules are used to alleviate toxicities despite no supportive evidence. This study aimed to analyze the toxicity and effectiveness of apatinib alone, especially with different dosing strategies in advanced gastric cancer patients under a real-world setting. Data from the subpopulation of patients who failed ≥2 chemotherapy regimens enrolled in the AHEAD-G202 trial were analyzed. The primary endpoint was safety. The secondary endpoints were overall survival (OS) and progression-free survival (PFS). Totally 120 patients were included into three groups by the initial daily doses: 43 (35.8%) patients in the low-dose (250 mg) group, 67 (55.8%) patients in the mid-dose (425 mg to 500 mg) group, and 10 (8.3%) patients in the high-dose (675 to 850 mg) group. Grade 3/4 treatment-emergent AEs were infrequent (<5%), with the most commonly reported grade 3/4 AEs being hand-foot syndrome (4.2%), hypertension (4.2%,), fatigue (4.2%), and difficulty in swallowing (4.2%) which gradually decreased among the high-, mid-, and low-dose groups. The median OS and PFS were 6.33 months (95% CI, 4.57-7.73) and 3.83 months (95% CI: 1.40-4.20), respectively and were comparable among the three doses groups. We found heavily pretreated advanced gastric cancer patients can tolerate and benefit from lower-doses of apatinib therapy. The lower initial daily dosing strategy represents an alternative approach for optimizing apatinib dosing in clinical practice. AJCR Copyright © 2020.

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出版当年[2020]版：

大类 | 2 区医学

小类 | 3 区肿瘤学

最新[2025]版：

大类 | 3 区医学

小类 | 4 区肿瘤学

第一作者：

第一作者机构： [1]Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing 100032, China.

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通讯作者：

通讯机构： [1]Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing 100032, China. [28]Department of Medical Oncology, Affiliated Hospital of Hebei University Baoding 071000, China. [29]Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital Tianjin 300060, China. [*1]Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100032, China [*2]Depart-ment of Medical Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China [*3]Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China.

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