Apatinib plus S-1 for previously treated, advanced gastric or
gastro-oesophageal junction adenocarcinoma: a phase 2, single-arm,
prospective study
Abstract
Aim: The current management of advanced gastric or gastro-oesophageal
junction adenocarcinoma remains unsatisfactory. We investigated the
efficacy and safety of the combination therapy of apatinib and S-1,
considering the potential advantage of home-based treatment without
hospital admission, in patients with platinum-refractory gastric or
gastro-oesophageal junction adenocarcinoma. Methods:Between April 2015
and May 2019, we included 37 patients with advanced gastric or
gastro-oesophageal junction adenocarcinoma refractory to first-line
platinum-containing therapy, who were treated with apatinib at an
initial dose of 500 mg once daily continuously and S-1 at a dose of
40-60 mg twice daily on days 1-14 of a 21-day cycle. The primary
endpoints were progression-free survival (PFS) and overall survival
(OS). The secondary endpoints were objective response rates, disease
control rates, and safety. Results:At the data cutoff, the median PFS
and OS were 4.2 months and 8.2 months, respectively. Of 37 eligible
patients, 8 (21.6%) patients reached objective responses, 31 (83.8%)
patients reached disease control. Grade 3 or 4 adverse events occurred
in 8 (21.6%) patients, including hand-foot syndrome, hypertension, and
diarrhea, etc. Conclusions: The combination of Apatinib and S-1 showed
promising efficacy and manageable toxicity as a home-based, second-line
therapy in patients with advanced gastric or gastro-oesophageal junction
adenocarcinoma refractory to platinum-containing therapy.