Journal of Gastric Cancer

  • 제22권4호
  • /
  • Pages.408-417
  • /
  • 2022
  • /
  • 2093-582X(pISSN)
  • /
  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
권호 표지
DOI QR코드

DOI QR Code

Apatinib as a Third-Line Treatment for HER2-Positive Metastatic Gastric Cancer: A Multi-Center Single-Arm Cohort Study

  • Zhang, Xin (Department of General Surgery, Handan Central Hospital) ;
  • Huo, Haoran (Department of General Surgery, Handan Central Hospital) ;
  • Nie, Yanan (Endoscopy Room, Han Gang Hospital) ;
  • Xue, Jiadong (Department of General Surgery, Handan Central Hospital) ;
  • Yuan, Zengjiang (Department of General Surgery, Handan Central Hospital) ;
  • Zhang, Zhenyi (Department of General Surgery, Handan Central Hospital)
  • 투고 : 2022.07.19
  • 심사 : 2022.08.29
  • 발행 : 2022.10.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Treatment options are limited after the failure of first-and second-line treatments in patients with HER2+ metastatic gastric cancer (mGC). The present study aimed to explore the efficacy, safety, and prognostic factors of apatinib efficacy as a third-line therapy for patients with human epithelial growth factor receptor 2-positive (HER2+) mGC. Materials and Methods: A total of 59 HER2+ mGC patients who received apatinib as third-line therapy were retrospectively enrolled in this two-center, single-arm, cohort study; the clinical response, survival data, and adverse events were retrieved. Results: The median progression-free survival (PFS) was 5.2 months (95% confidence interval [CI], 3.9-6.5), and the median overall survival (OS) was 8.2 months (95% CI, 6.6-9.8) Furthermore, forward stepwise multivariate Cox regression analysis showed that a higher Eastern Cooperative Oncology Group performance status score and multiple metastases were independently correlated with decreased PFS and OS (both P<0.05). The main adverse events were leukopenia (45.8%), hypertension (44.1%), thrombocytopenia (39.0%), hand-foot syndrome (37.3%), and elevated transaminase (33.9%). Grade 3 adverse events mainly included hypertension (5.1%) and neutropenia (5.1%); grade 4 adverse events did not occur. Conclusions: Apatinib is efficient and well tolerated in patients with HER2+ mGC as a third-line treatment, suggesting that it may be a candidate of choice for these patients.

키워드

참고문헌

  1. Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet 2020;396:635-648. https://doi.org/10.1016/S0140-6736(20)31288-5
  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. https://doi.org/10.3322/caac.21492
  3. Wang FH, Zhang XT, Li YF, Tang L, Qu XJ, Ying JE, et al. The Chinese Society of Clinical Oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer, 2021. Cancer Commun (Lond) 2021;41:747-795. https://doi.org/10.1002/cac2.12193
  4. Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R. Gastric cancer: epidemiology, risk factors, classification, genomic characteristics and treatment strategies. Int J Mol Sci 2020;21:4012. https://doi.org/10.3390/ijms21114012
  5. Shah SC, Canakis A, Peek RM Jr, Saumoy M. Endoscopy for gastric cancer screening is cost effective for Asian Americans in the United States. Clin Gastroenterol Hepatol 2020;18:3026-3039. https://doi.org/10.1016/j.cgh.2020.07.031
  6. Arslan C, Atilla FD. Modified docetaxel, cisplatin, and 5-fluorouracil combination regimen and capecitabine maintenance in metastatic gastric cancer: toxicity and efficacy results. Support Care Cancer 2022;30:4447-4455. https://doi.org/10.1007/s00520-022-06859-0
  7. Yoshioka T, Takahashi M, Sakamoto Y, Okita A, Fukui T, Murakawa Y, et al. Cisplatin plus capecitabine after adjuvant S-1 in metastatic gastric cancer: a phase II T-CORE1102 trial. Anticancer Res 2022;42:2009-2015. https://doi.org/10.21873/anticanres.15680
  8. Sakai D, Omori T, Fumita S, Fujita J, Kawabata R, Matsuyama J, et al. Real-world effectiveness of third- or later-line treatment in Japanese patients with HER2-positive, unresectable, recurrent or metastatic gastric cancer: a retrospective observational study. Int J Clin Oncol 2022;27:1154-1163. https://doi.org/10.1007/s10147-022-02162-4
  9. Ajani JA, D'Amico TA, Almhanna K, Bentrem DJ, Chao J, Das P, et al. Gastric cancer, version 3.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2016;14:1286-1312. https://doi.org/10.6004/jnccn.2016.0137
  10. Thuss-Patience PC, Shah MA, Ohtsu A, Van Cutsem E, Ajani JA, Castro H, et al. Trastuzumab emtansine versus taxane use for previously treated HER2-positive locally advanced or metastatic gastric or gastrooesophageal junction adenocarcinoma (GATSBY): an international randomised, open-label, adaptive, phase 2/3 study. Lancet Oncol 2017;18:640-653. https://doi.org/10.1016/S1470-2045(17)30111-0
  11. Satoh T, Xu RH, Chung HC, Sun GP, Doi T, Xu JM, et al. Lapatinib plus paclitaxel versus paclitaxel alone in the second-line treatment of HER2-amplified advanced gastric cancer in Asian populations: TyTAN--a randomized, phase III study. J Clin Oncol 2014;32:2039-2049. https://doi.org/10.1200/JCO.2013.53.6136
  12. Hecht JR, Bang YJ, Qin SK, Chung HC, Xu JM, Park JO, et al. Lapatinib in combination with capecitabine plus oxaliplatin in human epidermal growth factor receptor 2-positive advanced or metastatic gastric, esophageal, or gastroesophageal adenocarcinoma: TRIO-013/LOGiC--A randomized phase III trial. J Clin Oncol 2016;34:443-451.
  13. Roviello G, Catalano M, D'Angelo A, Palmieri VE. Second line of treatment for HER2-positive gastric cancer: an evolving issue. Rep Pract Oncol Radiother 2021;26:316-317. https://doi.org/10.5603/RPOR.a2021.0024
  14. Wagner AD, Grothe W, Haerting J, Kleber G, Grothey A, Fleig WE. Chemotherapy in advanced gastric cancer: a systematic review and meta-analysis based on aggregate data. J Clin Oncol 2006;24:2903-2909. https://doi.org/10.1200/JCO.2005.05.0245
  15. Kong F, Yao Y, Deng R, Li X, Jia Y. Hopes and failures in front-line advanced HER2-positive gastric cancer therapy. Anticancer Drugs 2021;32:675-680. https://doi.org/10.1097/CAD.0000000000001081
  16. Roviello G, Ravelli A, Fiaschi AI, Cappelletti MR, Gobbi A, Senti C, et al. Apatinib for the treatment of gastric cancer. Expert Rev Gastroenterol Hepatol 2016;10:887-892.
  17. Li H, Huang H, Zhang T, Feng H, Wang S, Zhang Y, et al. Apatinib: A novel antiangiogenic drug in monotherapy or combination immunotherapy for digestive system malignancies. Front Immunol 2022;13:937307. https://doi.org/10.3389/fimmu.2022.937307
  18. Xue JM, Astere M, Zhong MX, Lin H, Shen J, Zhu YX. Efficacy and safety of apatinib treatment for gastric cancer, hepatocellular carcinoma and non-small cell lung cancer: a meta-analysis. Onco Targets Ther 2018;11:6119-6128. https://doi.org/10.2147/OTT.S172717
  19. Fathi Maroufi N, Rashidi MR, Vahedian V, Akbarzadeh M, Fattahi A, Nouri M. Therapeutic potentials of Apatinib in cancer treatment: possible mechanisms and clinical relevance. Life Sci 2020;241:117106. https://doi.org/10.1016/j.lfs.2019.117106
  20. Yu GC, Yang J, Ye B, Xu LL, Li XY, Zheng GR. Apatinib in the treatment of advanced non-small-cell lung cancer: a meta-analysis. Math Biosci Eng 2019;16:7659-7670. https://doi.org/10.3934/mbe.2019383
  21. Li J, Qin S, Xu J, Xiong J, Wu C, Bai Y, et al. Randomized, double-blind, placebo-controlled phase III trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction. J Clin Oncol 2016;34:1448-1454. https://doi.org/10.1200/JCO.2015.63.5995
  22. Li J, Qin S, Xu J, Guo W, Xiong J, Bai Y, et al. Apatinib for chemotherapy-refractory advanced metastatic gastric cancer: results from a randomized, placebo-controlled, parallel-arm, phase II trial. J Clin Oncol 2013;31:3219-3225. https://doi.org/10.1200/JCO.2013.48.8585
  23. Meulendijks D, Beerepoot LV, Boot H, de Groot JW, Los M, Boers JE, et al. Trastuzumab and bevacizumab combined with docetaxel, oxaliplatin and capecitabine as first-line treatment of advanced HER2-positive gastric cancer: a multicenter phase II study. Invest New Drugs 2016;34:119-128. https://doi.org/10.1007/s10637-015-0309-4
  24. Kawamoto Y, Yuki S, Meguro T, Hatanaka K, Uebayashi M, Nakamura M, et al. Phase II study of continued trastuzumab plus irinotecan in patients with HER2-positive gastric cancer previously treated with trastuzumab (HGCSG 1201). Oncologist 2022;27:340-e374. https://doi.org/10.1093/oncolo/oyab062
  25. Kim BJ, Jee HJ, Rha SY, Han HS, Ryu MH, Park SH, et al. Ramucirumab plus paclitaxel as a second-line treatment in HER2-positive gastric cancer: subgroup analysis of a nationwide, real-world study in Korea (KCSG-ST19-16). Gastric Cancer 2022;25:609-618. https://doi.org/10.1007/s10120-021-01276-4
  26. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228-247. https://doi.org/10.1016/j.ejca.2008.10.026
  27. Shitara K, Bang YJ, Iwasa S, Sugimoto N, Ryu MH, Sakai D, et al. Trastuzumab deruxtecan in previously treated HER2-positive gastric cancer. N Engl J Med 2020;382:2419-2430. https://doi.org/10.1056/NEJMoa2004413
  28. Satoh T, Kang YK, Chao Y, Ryu MH, Kato K, Cheol Chung H, et al. Exploratory subgroup analysis of patients with prior trastuzumab use in the ATTRACTION-2 trial: a randomized phase III clinical trial investigating the efficacy and safety of nivolumab in patients with advanced gastric/gastroesophageal junction cancer. Gastric Cancer 2020;23:143-153. https://doi.org/10.1007/s10120-019-00970-8
  29. Jomrich G, Schoppmann SF. Targeting HER 2 and angiogenesis in gastric cancer. Expert Rev Anticancer Ther 2016;16:111-122. https://doi.org/10.1586/14737140.2016.1121110
  30. Jung YD, Mansfield PF, Akagi M, Takeda A, Liu W, Bucana CD, et al. Effects of combination anti-vascular endothelial growth factor receptor and anti-epidermal growth factor receptor therapies on the growth of gastric cancer in a nude mouse model. Eur J Cancer 2002;38:1133-1140. https://doi.org/10.1016/S0959-8049(02)00013-8
  31. Shao F, Zhang H, Yang X, Luo X, Liu J. Adverse events and management of apatinib in patients with advanced or metastatic cancers: a review. Neoplasma 2020;67:715-723. https://doi.org/10.4149/neo_2020_190801N701