<p>Clinical efficacy and survival analysis of apatinib combined with docetaxel in advanced esophageal cancer</p>

Abstract

Background and aim Standard chemotherapy has limited clinical efficacy in patients with esophageal cancer and there is a significant and unmet clinical need for effective treatment options for these patients. The aim of this study was to compare the clinical efficacy of the novel, targeted drug apatinib combined with docetaxel, and docetaxel combined with S-1 as second- or further-line treatment for patients with advanced esophageal cancer. Methods We enrolled 33 patients with advanced esophageal cancer in chemotherapy group or apatinib combined with chemotherapy group in this retrospective study. Apatinib (500 mg) was taken orally once daily; docetaxel was administered at a dose of 75 mg/m 2 ; and S-1 was optional at a dose of 40–60 mg, based on body surface area. The primary endpoint of this study was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), and the incidence and severity of adverse events (AEs). Results No complete response was observed in the two groups. However, two and five patients achieved partial response in the chemotherapy group and the apatinib combined with chemotherapy group, respectively. The ORR and DCR for the chemotherapy group was 11.1% and 33.3%, respectively. In the apatinib combination group, ORR and DCR was 88.9% and 93.3%, respectively. Anemia (11.1%) and neutropenia (5.6%) were the most frequent grade III/IV AEs observed in the chemotherapy group. In the apatinib combination group, the most frequent grade III/IV AEs were anemia (13.3%), hypertension (6.7%), and proteinuria (6.7%). Median PFS was significantly longer in the apatinib combination group than in the chemotherapy group (175 days vs 85 days, P =0.01). Conclusion The combination of apatinib and docetaxel has a manageable toxicity profile and may prolong survival. Therefore, this combination may be used as as second- or further-line treatment for patients with advanced esophageal cancer.

Apatinib suppresses tumor progression and enhances cisplatin sensitivity in esophageal cancer via the Akt/β-catenin pathway

“…In our study, we discovered that high VEGFR2 associated with poor clinical efficacy of cisplatin-based chemotherapy in advanced esophageal cancer. Existing clinical studies have shown that apatinib causes some adverse reactions, such as hypertension, hand and foot syndrome, proteinuria, diarrhea, and the incidence of adverse reactions are increased with the combination of regular dose of apatinib and chemotherapy [17,44]. Data from a clinical study have demonstrated that low dose apatinib plus chemotherapeutic agent is effective without increasing adverse reactions in lung cancer [45].…”

“…At present, a series of clinical trials of apatinib have been conducted and achieved improved clinical efficacy in multiple cancers, such as digestive tract cancer, breast cancer and lung cancer [10][11][12][13][14][15]. Few clinical retrospective studies have preliminarily suggested that apatinib alone or in combination with chemotherapy is efficacious for advanced esophageal cancer as a secondline or later treatment [16,17]. However, the possible function and mechanism of apatinib in the treatment of esophageal cancer is still poorly understood.…”

Safety and Efficacy of Apatinib Monotherapy for Unresectable, Metastatic Esophageal Cancer: A Single-Arm, Open-Label, Phase II Study

“…Apatinib is a novel inhibitor of angiogenesis that targets the intracellular adenosine triphosphate-binding site of VEGFR2 [12]. Apatinib has shown positive results as a second-or further-line treatment in patients with ESCC [13][14][15][16]. The overexpression of VEGF in esophageal cancer may be associated with a poor prognosis [17,18].…”

“…Apatinib has been demonstrated to have promising activity against gastric, breast, and lung tumors [12]. Moreover, a retrospective analysis concluded that apatinib (500 mg daily) combined with docetaxel may be effective as a second-line treatment for advanced esophageal cancer, with a median PFS of nearly 6 months, an ORR of 88.9%, and a DCR of 93.3% [14]. However, very few previous studies have explored the use of © AlphaMed Press 2020 Apatinib Monotherapy for Advanced Esophageal Cancer e1468 apatinib monotherapy in the setting of advanced cancer of the esophagus or gastroesophageal junction.…”

Advances in targeted therapy for esophageal cancer

“…61 Studies of apatinib combined with docetaxel for advanced ESCC have revealed that this combination therapy can be used as secondline or further treatment for patients with advanced ESCC. 62 Anlotinib. Anlotinib is a small-molecule inhibitor that can act on multiple targets.…”