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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1587069
This article is part of the Research Topic Novel Molecular Targets in Cancer Therapy View all 23 articles
Safety and efficacy of apatinib in combination treatment versus apatinib as second-line treatment for advanced gastric cancer
Provisionally accepted- Henan Provincial People's Hospital, Zhengzhou, China
Background: Apatinib is a systemic therapeutic agent for advanced gastric adenocarcinoma (GAC) and gastroesophageal junction adenocarcinoma (GEJA). Its efficacy can be enhanced by applying it as a combination therapy, but the evidence supporting its combination application as a second-line treatment is not well documented. In the current study, we aimed to assess the efficacy and safety profile of apatinib, both as a monotherapy and in combination regimens, for second-line treatment of GAC and GEJA in real-world settings. Methods: In this retrospective cohort analysis, we analyzed clinical data from 96 patients with advanced GAC or GEJA who received second-line apatinib monotherapy or combination therapy. Cox regression analysis was performed to identify prognostic factors influencing clinical outcomes of different treatment approaches (apatinib combination with other drugs). Results: The results indicated that the overall objective response rate (ORR) and disease control rate (DCR) for second-line apatinib monotherapy and combination therapy were 28.6% and 75.0%, respectively. The median progression-free survival (mPFS) was 4.5 months (range: 3.9-5.1 months), while the median overall survival (mOS) was 11.3 months (range: 7.4-15.1 months). Multivariable Cox regression analysis identified gender, liver metastasis, and peritoneal metastasis as independent predictors of inferior PFS and OS outcomes. In terms of safety, the primary adverse reactions included myelosuppression, elevated AST and ALT levels, hypertension, hand-foot syndrome, hyperbilirubinemia, proteinuria, fatigue, and vomiting, with a low incidence of grade 3–4 toxicities. Conclusions: Apatinib-based combination therapy significantly enhances both progression-free survival and overall survival in patients with advanced gastric cancer when compared to monotherapy, while also demonstrating a safe and reliable profile.
Keywords: gastric cancer, Apatinib, combination treatment, efficacy, Safety
Received: 03 Mar 2025; Accepted: 07 Apr 2025.
Copyright: © 2025 Zhang, Zhu, Wu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Peichun Sun, Henan Provincial People's Hospital, Zhengzhou, China
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