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KMID : 1141820220220040408
Journal of Gastric Cancer
2022 Volume.22 No. 4 p.408 ~ p.417
Apatinib as a Third-Line Treatment for HER2-Positive Metastatic Gastric Cancer: A Multi-Center Single-Arm Cohort Study
Zhang Xin

Huo Haoran
Nie Yanan
Xue Jiadong
Yuan Zengjiang
Zhang Zhenyi
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 third-line 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%), hand-foot 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 third-line treatment, suggesting that it may be a candidate of choice for these patients.
KEYWORD
Apatinib, Gastric cancer, Prognosis, Mortality, Safety
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