|
1
|
Qu J, He X, Luo Y, Yu P, Chen Y, Liu J, Wang X, Wang C, Liang T, Bai Y, Han Y, Man L, Leng C, Zhou C, He L, Wang X, Liu Y, Qu X. Evaluation of second-line apatinib plus irinotecan as a treatment for advanced gastric adenocarcinoma or gastroesophageal conjunction adenocarcinoma: a prospective, multicenter phase II trial. Front Oncol 2023; 13:1072943. [PMID: 37168383 PMCID: PMC10166633 DOI: 10.3389/fonc.2023.1072943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/27/2023] [Indexed: 05/13/2023] Open
Abstract
Objective Apatinib and irinotecan are used as systematic therapies for advanced gastric adenocarcinoma (GAC) and gastroesophageal junction adenocarcinoma (GEJA), while the evidence for their combination as second-line therapy in these patients is limited. This study aimed to evaluate the efficacy and safety of second-line apatinib plus irinotecan for the treatment of GAC and GEJA. Methods In this prospective, multicenter phase II clinical study, 28 patients with advanced GAC or GEJA who received second-line apatinib plus irinotecan were recruited. Results In total, 1 (3.6%) patient achieved complete response, 7 (25.0%) patients achieved partial response, 13 (46.4%) patients had stable disease, and 4 (14.3%) patients showed progressive disease, while clinical response was not evaluable or not assessed in 3 (10.7%) patients. The objective response rate and disease control rate were 28.6% and 75.0%, respectively. Meanwhile, the median (95% confidence interval (CI)) progression-free survival (PFS) was 4.5 (3.9-5.1) months, and the median (95% CI) overall survival (OS) was 11.3 (7.4-15.1) months. By multivariate Cox regression analysis, male sex, liver metastasis, and peritoneal metastasis were independently associated with worse PFS or OS, while treatment duration ≥5 months was independently associated with better OS. In terms of the safety profile, 89.3% of patients experienced treatment-emergent adverse events of any grade, among which 82.1% of patients had grade 1-2 adverse events and 64.3% of patients had grade 3-4 adverse events. Conclusion Apatinib plus irinotecan as second-line therapy achieves a good treatment response and satisfactory survival with tolerable safety in patients with advanced GAC or GEJA.
Collapse
Affiliation(s)
- Jinglei Qu
- Department of Medical Oncology, The First Hospital of China Medical University, China Medical University, Shenyang, China
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China
- Clinical Cancer Research Center of Shenyang, The First Hospital of China Medical University, Shenyang, China
| | - Xin He
- Department of Medical Oncology, The First Hospital of China Medical University, China Medical University, Shenyang, China
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China
- Clinical Cancer Research Center of Shenyang, The First Hospital of China Medical University, Shenyang, China
| | - Ying Luo
- Department of Medical Oncology, The First Hospital of China Medical University, China Medical University, Shenyang, China
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China
- Clinical Cancer Research Center of Shenyang, The First Hospital of China Medical University, Shenyang, China
| | - Ping Yu
- Department of Medical Oncology, The First Hospital of China Medical University, China Medical University, Shenyang, China
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China
- Clinical Cancer Research Center of Shenyang, The First Hospital of China Medical University, Shenyang, China
| | - Ying Chen
- Department of Medical Oncology, The First Hospital of China Medical University, China Medical University, Shenyang, China
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China
- Clinical Cancer Research Center of Shenyang, The First Hospital of China Medical University, Shenyang, China
| | - Jing Liu
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin Wang
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Chang Wang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Tingting Liang
- Cancer Center, The First Hospital of Jilin University, Changchun, China
| | - Yuxian Bai
- Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yu Han
- Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Li Man
- Department of Medical Oncology, Anshan Cancer Hospital, Anshan, China
| | - Chuanchun Leng
- Department of Medical Oncology, The Central Hospital of Anshan, Anshan, China
| | - Caiyun Zhou
- The Fourth Oncology Departments, Huludao Central Hospital, Huludao, China
| | - Lijie He
- Department of Medical Oncology, People’s Hospital of Liaoning Province, Shenyang, China
| | - Xin Wang
- Department of Medical Oncology, General Hospital of Benxi Iron and Steel Industry Group of Liaoning Health Industry Group, Benxi, China
| | - Yunpeng Liu
- Department of Medical Oncology, The First Hospital of China Medical University, China Medical University, Shenyang, China
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China
- Clinical Cancer Research Center of Shenyang, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Xiujuan Qu, ; Yunpeng Liu,
| | - Xiujuan Qu
- Department of Medical Oncology, The First Hospital of China Medical University, China Medical University, Shenyang, China
- Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, China
- Liaoning Province Clinical Research Center for Cancer, Shenyang, China
- Clinical Cancer Research Center of Shenyang, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Xiujuan Qu, ; Yunpeng Liu,
| |
Collapse
|