| Background and purposeGastric cancer which is the third leading tumor of death after lung cancer and liver cancer in the world is more common in Southeast Asia, the central and eastern Europe, American South ect[1]. Among the 1,000,000 newly case of gastric cancer,there are more than 70% of that in Southeast Asia and half of that are in China every year in the world.The morbidity of gastric cancer in China in a variety of malignant tumors ranks the second place and the mortality ranks the third place.According to the studies in China, the discovery rate of early gastric cancer is only 2%~4% [2].Most time,the gastric cancer has been locally advanced or systematically mutiple metastatic so that there is no operation indication. Therefore, the patients often missed the opportunities of surgical treatments. Compared with the best supportive care,although chemotherapy could improve the living quality and prolong the life span of the patients,the overall survival is short and the median overall survival is still less than 1 year [3].Besides, owing to the chemotherapeutic drug targets also assist in the normal cells,the advise reactions are easier to produce with the increase of chemotherapy cycles[4].With the development of molecular biology, a new therapeutic method---tumor’s molecular target therapy is flourishing gradually. Rencent years, this therapy method whose mechanism of action aims at treating tumor in the molecular pathway by usingthe monoclonal antibody or small-molecular drugs which can cut off the relative paths of the key targets for overexpression or abnormal activation of cancer cells against some molecular pathways in the procession of the incidences, developments and metastatics of the tumors has been an important part in the treatment of tumors[5].What’s more, the advise reaction is slighter than that of those patients who accept chemotherapy and most of patients can torlerant them. As a result,it has been an importent part of clinical treatment of tumors.Antiangiogenic agents has become one of the hot spot of research. Avastin,a kind of antiangiogenic drugs of foreign countries disappointed people through the third AVAGAST clinical studies. Apatinib is a kind of new type targeted drug which is studied as inhibitors of tyrosinase, a molecular of endothelium growth factor by Chinese, however few publications have done in-depth features on it.The aim of this study is to explore the efficacy and safety of Apatinib by retrospectively analyzing clinical data of sixty advanced gastric cancer patients who received second line or beyond treatment from November 2014 to December 2015.Datas and Methods From November 2014 to December 2015, sixty patients with pathological diagnosis of advanced gastric cancer who received second line or beyond treatment were enrolled in the study. All the patients were given Apatinib 850mg/d orally until disease progression. Clinical efficacy and adverse reactions were observed.Statistical MethodsAll data are analyzed statistically by SPSS17.0 statistical software, categorical data are analyzed by chi-square test, Kaplan-Meier method was used for survival analysis. P <0.05 was considered statistically significant.Results1. According to the RECIST standard, all the patients can be evaluated therapeutic effects. CR rate was 0%(0/60), PR rate was 3.33%(2/60), SD rate was38.33(23/60), and PD rate was 58.33%(35/60). The objective response rate(CR+PR)and the disease control rate(CR+PR+SD) were 3.33% and 38.33%(23/60),respectively.2. Comparing the short-term effect of AFP-positive patients and AFP-negative patients: the DCR rate of AFP-positive gastric cancer patients is 63.64%,compared with AFP-negative patients,the difference is statistically significant.(63.64% vs32.65%, P = 0.012 <0.05).3. The long-term effect and factors influencing efficacy of apatinib: The median progression-free survival time of all patients was 3.76 months. The difference of PFS between AFP-positive patients and AFP-negative patients is statistically significant(2.9mvs5.7m, P <0.05).4. Adverse reactions can be tolerated, or can be controlled,and the main adverse reactions were hypertension and bone marrow suppression.ConclusionAdministration of Apatinib in advanced gastric cancer patients after failure of second-line or beyond treatment is still beneficial due to the higher disease control rate and better survival, and the adverse reactions is tolerable, being worthy of clinical generalization and further clinical observation. |
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