Clinical efficacy and safety of apatinib as maintenance treatment in patients with advanced esophageal squamous cell carcinoma

Abstract

Background: To investigate the clinical e cacy,safety and prognostic factors of the therapy that apatinib is used for maintenance treatment in patients with advanced esophageal squamous cell carcinoma.Methods: We select 46 patients with advanced esophageal squamous cell carcinoma treated with radiotherapy and chemotherapy in our hospital from January 2017 to February 2019, all of them were treatment with apatinib. Analysis the clinical e cacy, adverse reactions and prognostic factors. Meanwhile, the expression of patients'VEGFR-2 NF-kB was detected by immunohistochemical SABC method,and the microvessel density and microlymphatic tube density were counted.Analysis of the relationship between indicators and MVD, MLVD counts and the e cacy of apatinib.Results: We found that oral treatment of apatinib in VEGFR-2 NF-kB positive group was better than that in negative group. The partial remission rate of patients was 26.09%; the disease control rate was 67.39%.The main adverse reactions were hypertension (60.87%); hand and foot syndrome (34.77%); proteinuria (36.96%). The degree of adverse reactions was mainly grade 1~2. The median progression-free survival was 3.7 months and the median overall survival was 7.2 months.Log-Rank univariate analysis showed that the degree of adverse reactions and ECOG score were related to OS in patients with advanced esophageal squamous cell carcinoma.Cox multivariate regression analysis showed that the degree of adverse reactions and ECOG score were independent factors affecting OS in patients with advanced esophageal squamous cell carcinoma. Conclusion:Positive expression of VEGFR-2 and NF-kB can be used as a biological reference target for targeted treatment of oral apatinib. Apatinib has a certain clinical effect in the maintenance treatment of advanced esophageal squamous cell carcinoma patients after treatment, with mild adverse reactions and high safety.

Acute Hypertensive Retinochoroidopathy Secondary to an Anti-cancer Drug (apatinib): The First Case Report

“…Apatinib is a novel, oral, small-molecule, highly selective VEGFR-2 inhibitor, which has been proven to be well-tolerated and effective for gastric cancer patients ( 5 – 7 ). However, hypertension, abnormal liver function, haematological toxicity, and proteinuria have been reported as frequent adverse events ( 7 , 8 ).…”

“…Apatinib is a highly selective vascular endothelial growth factor receptor-2 (VEGFR-2) inhibitor, which has been proven effective and safe for cancer patients (5)(6)(7). However, several side effects have been reported such as hypertension, abnormal liver function, haematologic toxicity, and proteinuria (7,8).…”

Current and emerging anti-angiogenic therapies in gastrointestinal and hepatobiliary cancers

“…There are currently no anti-angiogenic therapies approved for the treatment of oesophageal cancer. Small anti-angiogenic molecules such as sunitinib (in combination with paclitaxel or FOLFIRI) or sorafenib (in combination with docetaxel and cisplatin), erlotinib (with bevacizumab and neoadjuvant chemoradiation), apatinib (as maintenance treatment after chemo-radiation in localised oesophageal squamous cell carcinoma) or anlotinib (as monotherapy in the refractory setting) have shown limited or no efficacy in small phase II trials (150)(151)(152)(153)(154). Combinations of TKIs with immunotherapy are being evaluated (155).…”

Targeting the Microenvironment in Esophageal Cancer

“…A variety of VEGF/VEGFR inhibitors have been developed, including anlotinib, apatinib, sorafenib, sunitinib, ramucirumab, and bevacizumab ( Table 1 ). Of these, anlotinib, apatinib, sorafenib, and ramucirumab have been shown to have clinical benefits in patients with EC during clinical trials ( Wilke et al, 2014 ; Xu et al, 2014 ; Janjigian et al, 2015 ; Moehler et al, 2016 ; Cunningham et al, 2017 ; Liu G. et al, 2020 ; Yang Y. M. et al, 2020 ; Huang et al, 2021 ). The positive effect of Endostar combined with radiotherapy and chemotherapy in the treatment of ESCC has been reported and similar clinical trials are ongoing ( Xu et al, 2014 ).…”