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Apatinib Monotherapy for Chemotherapy-Refractory Metastatic Colorectal Cancer: A Multi-centre, Single-Arm,

Fen Wang1, Xia Yuan2, Jun Jia3

  • 1Department of Oncology, Peking University Shenzhen Hospital, Guangdong, China.

Scientific Reports
|April 10, 2020
PubMed

Insights

Apatinib shows promise for metastatic colorectal cancer (mCRC) patients resistant to chemotherapy. This angiogenesis inhibitor demonstrated manageable side effects and potential predictive markers for treatment efficacy.

Area of Science:

  • Oncology
  • Medical Research
  • Pharmacology

Background:

  • Metastatic colorectal cancer (mCRC) presents challenges in treatment, especially after failure of standard chemotherapy.
  • Angiogenesis inhibitors are a key area of interest for improving outcomes in mCRC.
  • Identifying effective treatments for chemotherapy-refractory mCRC is crucial.

Purpose of the Study:

  • To evaluate the efficacy and safety of apatinib in patients with chemotherapy-refractory mCRC.
  • To assess progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), overall survival (OS), and toxicity.
  • To identify potential predictive biomarkers for apatinib efficacy.

Main Methods:

  • A phase trial involving 48 patients with mCRC who progressed after at least two lines of standard chemotherapy.
  • Daily administration of apatinib 500 mg.
  • Analysis of primary endpoints (PFS) and secondary endpoints (ORR, DCR, OS, toxicity).

Main Results:

  • Apatinib demonstrated an ORR of 8.3% and a DCR of 68.8%.
  • Median PFS was 4.8 months and median OS was 9.1 months.
  • Common grade 3-4 adverse events included hypertension, hand-foot syndrome (HFS), thrombocytopenia, and proteinuria. Low baseline neutrophil/lymphocyte ratio (NLR), early carbohydrate antigen 19-9 (CA19-9) decrease, and HFS predicted improved PFS.

Conclusions:

  • Apatinib monotherapy shows encouraging efficacy and manageable toxicity in chemotherapy-refractory mCRC.
  • Previous anti-angiogenic therapies did not impact outcomes.
  • Baseline NLR, early CA19-9 decrease, and HFS can serve as predictive biomarkers for apatinib efficacy.

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