Efficacy and safety of apatinib in patients with recurrent or metastatic head and neck squamous cell carcinoma: a retrospective multi-center study

Abstract

Apatinib is a novel antiangiogenic agent that targets vascular endothelial growth factor 2. The aim of our study was to explore the efficacy and safety of apatinib in the treatment of patients with recurrence or metastasis (R/M) inoperable head and neck squamous cell carcinoma (HNSCC). This multi-center retrospective study analyzed 53 cases of recurrent or metastatic inoperable HNSCC who had progressed or recurred after undergoing standard radiotherapy, chemotherapy, and immunotherapy treated with apatinib from March 2017 to August 2021. Patients continued apatinib until the time of disease progression or onset of intolerable adverse events. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate (ORR), and disease control rate (DCR) and incidence of adverse events. Univariable and multivariable analyses were performed to determine prognostic factors. The main adverse events were counted, and the severity of the adverse reactions was evaluated. Fifty-three patients with recurrent or metastatic inoperable R/M HNSCC who had progressed or recurred after standard radiotherapy, chemotherapy, and immunotherapy were included. The ORR was 15.1%, and the DCR was 86.8%. The median PFS was 4.4 months (95% confidence interval [CI] 3.7–5.0 months) and the median OS was 6.6 months (95% CI 5.3–7.9 months). The number of apatinib lines was an influencing factor for both PFS and OS, and the Eastern Cooperative Oncology Group (ECOG) score, tumor differentiation, and apatinib duration were only the influencing factors for OS. Of these, only the ECOG score was an independent predictor of OS. The most common adverse reactions were hypertension (39.6%), hand-foot syndrome (32.1%), fatigue (32.1%), oral ulcers (28.3%), and nausea and vomiting (20.8%). Most adverse reactions were grade 1 or 2. Apatinib mesylate has good efficacy for recurrent/metastatic inoperable HNSCC as second-line and above-line treatment. ECOG score was an independent prognostic factors of OS in patients who were treated with apatinib. In addition, the adverse effects of apatinib mesylate were relatively mild.

Apatinib in recurrent or metastatic head and neck cancer patients

“…In a retrospective study of 53 cases of apatinib for recurrent and metastatic head and neck cancers, an ORR of 15.1% and a DCR of 86.8% were reported. The median OS was 6.6 months and median PFS was 4.4 months [20]. Comparably, in our study, the ORR was 21.2% and DCR was 70.6%.…”

A Novel Preclinical In Vitro 3D Model of Oral Carcinogenesis for Biomarker Discovery and Drug Testing

“…For this purpose, two inhibitors associated with VEGF-VEGFR signalling, pazopanib and lenvatinib, were selected. Targeting angiogenesis has become an attractive therapeutic strategy for several types of cancer, including head and neck SCC [ 49 , 50 ]. A recent study demonstrated supporting evidence of the efficacy of apatinib mesylate, a novel anti-angiogenic agent, in the management of recurrent/metastatic inoperable HNSCC [ 50 ].…”

The efficacy and safety of EGFR‐TKI in recurrent/metastatic nasopharyngeal carcinoma patients: A systematic review and meta‐analysis

“…They selectively target the ATP binding site within the cells and have high affinity. Their effectiveness has been confirmed in various solid tumors, 8 and in recent years, their efficacy has also been reported in many head and neck tumors 9 . In fact, in recent years, trials of EGFR‐TKIs (e.g., erlotinib, afatinib) in the treatment of rmNPC patients have shown promising results with a lower rate of grade 3–4 adverse reactions.…”

“…Their effectiveness has been confirmed in various solid tumors, 8 and in recent years, their efficacy has also been reported in many head and neck tumors. 9 In fact, in recent years, trials of EGFR‐TKIs (e.g., erlotinib, afatinib) in the treatment of rmNPC patients have shown promising results with a lower rate of grade 3–4 adverse reactions. Compared to the past, these new TKIs have more suitable pharmacological mechanisms, selectively targeting a single receptor kinase pathway and enhancing affinity for receptor binding, thus requiring lower concentrations to achieve inhibitory effects and resulting in fewer drug toxicities.…”