Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer

Li, N.

doi:10.1093/annonc/mdz247.129

Cited by 3 publications

(5 citation statements)

References 21 publications

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“…It is consistent with previous case reports on the e cacy of antiangiogenic therapy in AFPGC (17). One study suggested PD-1 checkpoint inhibitor plus chemotherapy could be bene t for AFPGC (15). AFPGC patients respond to immunotherapy, possibly associated with their speci c genetic features.…”

Section: Discussionsupporting

confidence: 90%

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The combination of Tislelizumab and apatinib obtained complete remission for alpha-fetoprotein-producing gastric cancer with microsatellite stability: case report

Xiang¹,

Wang²,

Gong³

et al. 2021

Preprint

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BackgroundAlpha‑fetoprotein (AFP)‑producing gastric cancer (AFPGC) is a rare type of gastric cancer with high metastasis rate and poor prognosis. Despite substantial progress in the treatment of many solid tumors, there are no reports of the safety and effectiveness of immune checkpoint inhibitor (ICI) in combination with anti-angiogenesis in AFPGC patients with microsatellite stability (MSS).Case presentationThis is a case of a 69-year-old man who was diagnosed with metastatic AFPGC. After the progression of resistance to chemotherapy, Tislelizumab combined with apatinib was attempted, although the patient was microsatellite stable. With 3 cycles of combination therapy, a partial remission (PR, shrunk by 56%) was obtained, and the quality of life improved significantly. Surprisingly, after more than one year of continuous application of the above treatment regimen, both the primary and metastatic tumors in this patient eventually disappeared, which achieved complete remission (CR) without surgery. Following the combined treatment, the patient had a progression-free survival of more than 16 months and now is still in continue to benefit. ConclusionsThis is the first report that we are aware of on the effective treatment of AFPGC with Tislelizumab in combination with Apatinib. This provides a highly effective and tolerable therapeutic strategy for microsatellite-stabilized AFPGC.

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Section: Discussionsupporting

confidence: 90%

“…Up to now, three articles have reported that apatinib has a good effect on AFPGC (15,16), which suggested that antiangiogenic treatment may also be an option. It is consistent with previous case reports on the e cacy of antiangiogenic therapy in AFPGC (17).…”

Section: Discussionmentioning

confidence: 99%

The combination of Tislelizumab and apatinib obtained complete remission for alpha-fetoprotein-producing gastric cancer with microsatellite stability: case report

Xiang¹,

Wang²,

Gong³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…However, Wang et al reported that the triplet regimen as first-line chemotherapy improved the prognosis of AFPGC accompanied by liver metastasis [14]. Li et al and Wang et al reported that apatinib had a good effect on AFPGC [15,16], which is consistent with a case report by Arakawa et al on the efficacy of antiangiogenic therapy of AFPGC [17]. However, apatinib alone has limited efficacy in treatment of AFPGC.…”

Section: Discussionsupporting

confidence: 68%

“…The median progression-free survival of patients administered apatinib was 3.5 months (95% CI: 2.34-4.66). The median overall survival was 4.5 months (95% CI: 3.49-5.51) [15]. Li et al suggested that PD-1 checkpoint inhibitors plus chemotherapy could be beneficial for AFPGC [18].…”

Section: Discussionmentioning

confidence: 99%

Complete remission of alpha-fetoprotein-producing gastric cancer by combined tislelizumab-apatinib treatment of a patient with proficient mismatch repair: a case report

et al. 2022

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Background Alpha‑fetoprotein-producing gastric cancer (AFPGC) is a rare type of gastric cancer with a high rate of metastasis and poor prognosis. Despite substantial progress in the treatment of many solid tumors, there are no reports of the safety and effectiveness of immune checkpoint inhibitors in combination with antiangiogenesis agents for AFPGC patients who have proficient mismatch repair. Case presentation We describe a 69-year-old man who was diagnosed with metastatic AFPGC. After progression to chemotherapy resistance, tislelizumab combined with apatinib was administered, although the patient’s gastroscopic pathology showed proficient mismatch repair. After three cycles of therapy, partial remission (reduced by 56%) was obtained, and the quality of life improved significantly. Surprisingly, after more than 1 year of continuous application of the combination treatment regimen, both the primary and metastatic tumors in this patient eventually disappeared, which obtained complete remission without surgery. The patient has had a progression-free survival of more than 24 months and is still continuing to benefit. Conclusions This case is the first example of effective treatment of AFPGC with tislelizumab combined with apatinib. The outcomes of this case suggest a highly effective and tolerable therapeutic strategy for microsatellite-stabilized AFPGC.

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“…There are no established treatment guidelines for AFPGC. Treatment of AFPGC usually follows that of cGC, with radical surgery regarded as the first-line approach, followed by adjuvant chemotherapy or targeted therapy if needed [such as S-1-based chemotherapies (29) or apatinib combined with other drugs (30)]. Trastuzumab has been confirmed as an additional useful therapeutic standard option for patients with HER2-positive advanced GCs and in aggressive variants of adenocarcinomas such as HER2-positive AFPGCs (31).…”

Section: Discussionmentioning

confidence: 99%

Decreased expression of claudin-18.2 in alpha-fetoprotein-producing gastric cancer compared to conventional gastric cancer

Weng¹,

Zhang²,

Ni³

et al. 2022

J Gastrointest Oncol

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Background: Alpha-fetoprotein-producing gastric cancer (AFPGC) is a subtype of gastric cancer (GC) with more aggressive biological behavior. As a highly specific tight junction component exclusively present in gastric mucosa and gastric adenocarcinomas, claudin-18.2 (CLDN18.2) has become an emerging target in GC. In this study, we aimed to provide insight into AFPGC and investigate the expression and the clinical implications of CLDN18.2 in AFPGC.Methods: We retrospectively collected 98 cases of AFPGC and reviewed their clinical, morphological, and immunohistochemical features. Another 356 patients with stage-matched conventional GC (cGC) were enrolled as a control group. We further surveyed CLDN18.2 expression by immunohistochemistry (IHC) in 51 AFPGC tissues and explained its association with the clinicopathological parameters of AFPGC.Results: Our results showed that AFPGC was a unique GC type with elevated serum alpha-fetoprotein (AFP), which was a predictor of a worse prognosis. AFPGC showed typical morphological features and positive staining of at least 1 hepatocytic or enteroblastic marker. The expression rate of CLDN18.2 was low, with a positivity rate of 21.6%, which was much lower than that observed in cGC tissues (38.5%). A significant correlation was found between CLDN18.2 expression and the differentiation of AFPGC. CLDN18.2 expression was negatively correlated with the serum AFP level of AFPGC. We also found that AFPGC with a hepatoid type (HPT) component showed a significantly lower CLDN18.2 expression than those without.Conclusions: This study demonstrated that CLDN18.2 was significantly decreased in AFPGC and was negatively correlated with the patient's preoperative serum AFP level. The negative correlation between AFP and CLDN18.2 could be explained by retro-differentiation of AFPGC. Special treatment strategies might be needed for this unique tumor type.

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Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer

Cited by 3 publications

References 21 publications

The combination of Tislelizumab and apatinib obtained complete remission for alpha-fetoprotein-producing gastric cancer with microsatellite stability: case report

The combination of Tislelizumab and apatinib obtained complete remission for alpha-fetoprotein-producing gastric cancer with microsatellite stability: case report

Complete remission of alpha-fetoprotein-producing gastric cancer by combined tislelizumab-apatinib treatment of a patient with proficient mismatch repair: a case report

Decreased expression of claudin-18.2 in alpha-fetoprotein-producing gastric cancer compared to conventional gastric cancer

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