Apatinib Monotherapy for Chemotherapy-Refractory Metastatic Colorectal Cancer: A Multi-centre, Single-Arm, Prospective Study

Autor: Zeqiang Zhou, Jianxin Lu, Xia Li, Minghui Deng, Xiaoxia Bi, Qiming Zhou, Shubin Wang, Liangjie Yi, Fen Wang, Hanbin Chen, Jun Jia, Yu Zhu, Xia Yuan, Wenzhi Su, Changguo Luo, Yong Li
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Oncology
Pyridines
Colorectal cancer
medicine.medical_treatment
lcsh:Medicine
Biomarkers
Pharmacological
chemistry.chemical_compound
0302 clinical medicine
Clinical endpoint
Apatinib
Prospective Studies
Neoplasm Metastasis
lcsh:Science
Prospective cohort study
Aged
80 and over
Multidisciplinary
Hazard ratio
Middle Aged
Prognosis
Fluorouracil
030220 oncology & carcinogenesis
Female
Colorectal Neoplasms
medicine.drug
Adult
medicine.medical_specialty
Antineoplastic Agents
Article
03 medical and health sciences
Targeted therapies
Internal medicine
medicine
Humans
Antigens
Tumor-Associated
Carbohydrate
Adverse effect
Aged
Chemotherapy
business.industry
lcsh:R
medicine.disease
Survival Analysis
030104 developmental biology
chemistry
Drug Resistance
Neoplasm
lcsh:Q
business
Tumour angiogenesis
Follow-Up Studies
Zdroj: Scientific Reports
Scientific Reports, Vol 10, Iss 1, Pp 1-13 (2020)
ISSN: 2045-2322
DOI: 10.1038/s41598-020-62961-5
Popis: Angiogenesis inhibitors are of considerable interest for treating metastatic colorectal cancer (mCRC). This trial evaluated the efficacy and safety of apatinib in chemotherapy-refractory mCRC. Apatinib 500 mg was administered daily to patients who had progressed after two or more lines of standard fluorouracil-based chemotherapy. Primary endpoint was progression-free survival (PFS). Secondary endpoints were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and toxicity. Overall, 48 patients were enrolled. ORR and DCR were 8.3% (4/48) and 68.8% (33/48), respectively. Median PFS and OS were 4.8 (95% confidence interval [CI], 3.653–5.887) and 9.1 months (95% CI, 5.155–13.045), respectively, and did not differ between subgroups stratified by previous anti-angiogenic therapies. The most prevalent grade 3–4 adverse events were hypertension (12.5%), hand-foot syndrome (HFS, 10.4%), thrombocytopenia (10.4%), and proteinuria (8.3%). Low baseline neutrophil/lymphocyte ratio (NLR, hazard ratios [HR], 0.619; P = 0.027), early carbohydrate antigen 19–9 (CA19–9) decrease (HR, 1.654; P = 0.016), and HFS (HR, 2.087; P = 0.007) were associated with improved PFS. In conclusion, apatinib monotherapy demonstrated encouraging efficacy with manageable toxicities in chemotherapy-refractory mCRC. Previous anti-angiogenic therapies did not influence outcomes. Baseline NLR, early CA19-9 decrease, and HFS could predict the efficacy of apatinib.
Databáze: OpenAIRE
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