Case Report And Literature Review Of Apatinib For Treating Metastatic Colorectal Cancer

Apatinib,a novel small-molecule tyrosine kinase inhibitor that inhibits vascular endothelial growth factor receptor-2,thus decrease neovascularization in tumor environments.Apatinib has been approved for metastatic gastric adenocarcinoma in China in Dec 2014.Colorectal cancer(CRC)is one of the most frequently diagnosed cancer in the world,approximately 20% of patients who are initially diagnosed with CRC are metastatic,and almost 50% of patients who initially presented with early stage CRC will finally develop metastasesThis is the first report on its use for advanced colorectal cancer as a kind of third-line therapy to date.Here we report two metastatic colorectal cancer Chinese patients who failed with second-line therapy,received apatinib as third-line therapy and their survivals were prolonged with a good safety and tolerability profile.Both two patients achieved favorable benefits in outcomes after the administration of apatinib.Patient 1 benefited 4 months progressive free survival(PFS)and 11 months overall survival(OS),while patient 2’s PFS was over 10 months.Both two patients presented drug related adverse event,hand-foot syndrome,and one of them suffered a slight impair of liver function(elevated transaminases and bilirubin),mild elevated blood pressure and slight proteinuria.But these adverse events were manageable with symptomatic treatment and dose reduction or a short time drug withdrawal,and didn’t influence the subsequent treatment.In conclusion,both two late stage metastatic colorectal cancer patients who failed with second-line or above treatments,received good therapeutic efficacy and good safety profile after taking apatinib.