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Treatment Response, Survival Benefit and Safety Profile of PD-1 Inhibitor Plus Apatinib Versus Apatinib Monotherapy
Dengdeng Pan1,2, Dongliang Liu3, Lichuan Liang3
1Department of General Surgery, Anhui Medical University, Hefei, China.
Purpose:
Programmed cell death protein 1 (PD-1) inhibitor plus apatinib is reported to be a promising strategy for advanced cancers. Moreover, a PD-1 inhibitor or apatinib exerts a certain efficacy in advanced colorectal cancer (CRC), whereas their synergistic effect is unclear. This study aimed to evaluate the treatment efficacy and safety of a PD-1 inhibitor plus apatinib in advanced CRC patients.
Methods:
In total, 45 advanced CRC patients who received a PD-1 inhibitor plus apatinib (PD-1 inhibitor plus apatinib group, N=20) or apatinib monotherapy (apatinib group, N=25) as third-line therapies were enrolled in the current study.
Results:
The objective response rate (20.0% vs. 8.0%) (P=0.383) and disease control rate (70.0% vs. 52.0%) (P=0.221) were numerically increased in the PD-1 inhibitor plus apatinib group, respectively, compared with the apatinib group, but no statistical significance was observed. The median progression-free survival (PFS) was 7.5 versus 4.8 months; the 1-year PFS rate was 32.5% versus 9.9%; the median overall survival (OS) was 12.3 versus 8.7 months; and the 1-year OS rate was 50.7% versus 27.0% in the PD-1 inhibitor plus apatinib group versus the apatinib group, respectively. PFS (P=0.038) and OS (P=0.048) were prolonged in the PD-1 inhibitor plus apatinib group compared with the apatinib group. PD-1 inhibitor plus apatinib (versus apatinib) was independently associated with longer PFS (P=0.012) and OS (P=0.009). The majority of the adverse events were of grade 1-2, wherein the incidence was similar between groups, except for the fact that the incidence of capillary proliferation was elevated in the PD-1 inhibitor plus apatinib group compared with the apatinib group (25.5% versus 0.0%) (P=0.013).
Conclusion:
PD-1 inhibitor plus apatinib presents a potential improvement in efficacy and survival benefit compared with apatinib monotherapy, with tolerable safety in advanced CRC patients.
Insights
Combining a programmed cell death protein 1 (PD-1) inhibitor with apatinib shows improved survival benefits for advanced colorectal cancer (CRC) patients. This combination therapy offers a potential survival advantage over apatinib monotherapy with manageable side effects.
Area of Science:
- Oncology
- Immunotherapy
- Gastrointestinal Cancers
Background:
- Programmed cell death protein 1 (PD-1) inhibitors and apatinib are individually effective in advanced cancers.
- The synergistic effect of combining PD-1 inhibitors with apatinib in advanced colorectal cancer (CRC) remains unclear.
- This study investigates the combined efficacy and safety of these agents in advanced CRC.
Purpose of the Study:
- To evaluate the treatment efficacy of PD-1 inhibitor plus apatinib versus apatinib monotherapy in advanced CRC patients.
- To assess the safety profile of the combination therapy.
- To determine the impact on progression-free survival (PFS) and overall survival (OS).
Main Methods:
- A cohort of 45 advanced CRC patients received either PD-1 inhibitor plus apatinib (N=20) or apatinib monotherapy (N=25) as third-line treatment.
- Objective response rate (ORR) and disease control rate (DCR) were assessed.
- Progression-free survival (PFS) and overall survival (OS) were analyzed.
Main Results:
- The PD-1 inhibitor plus apatinib group showed numerically higher ORR (20.0% vs. 8.0%) and DCR (70.0% vs. 52.0%), though not statistically significant.
- Median PFS was significantly prolonged (7.5 vs. 4.8 months, P=0.038) and median OS was significantly improved (12.3 vs. 8.7 months, P=0.048) in the combination group.
- The combination therapy was independently associated with longer PFS (P=0.012) and OS (P=0.009).
- Adverse events were mostly grade 1-2, with increased capillary proliferation observed in the combination group (25.5% vs. 0.0%, P=0.013).
Conclusions:
- PD-1 inhibitor plus apatinib demonstrates a potential improvement in efficacy and survival benefit for advanced CRC patients compared to apatinib monotherapy.
- The combination therapy exhibits a tolerable safety profile.
- This strategy warrants further investigation for advanced colorectal cancer treatment.
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