Clinical Efficacy And Prognostic Factors Of Apatinib In The Treatment Of Advanced Breast Cancer

BackgroundBreast cancer is the most common malignant tumor which effects the women's health and lives.In recent years,the incidence of breast cancer is on the rise in all countries of the world and breast cancer is the leading cause of cancer death from ages 20 to 59 years among women.For patients with advanced breast cancer,especially those who were after failure of prior lines of chemotherapy or suffering from the recurrence or metastases,there is still a lack of standard treatment.Angiogenesis is one of the key links in malignant growth of tumors.In recent years,apatinib,a target drug for neovascularization,has become a research hotspot in advanced malignant tumors.PurposeTo discuss the efficacy and safety of apatinib and find the independent prognostic factors.MethodsWe retrospectively analyzed the clinical data of 73 patients with advanced breast cancer of Oncology and Breast Surgery Department in the First Affiliated Hospital of Zhengzhou University who had received apatinib after failure of prior therapy or suffering from the recurrence or metastases between September 06,2016and November 01,2018.All patients took the apatinib 500mg,once/day,combination patients combined the chemotherapy with apatinib,deviding the single agent apatinib group and combination chemotherapy containing apatinib group.We observed the efficacy and safety of two groups and the side effects relating the therapy.Results1.Short-term effect and predictive factors:After the therapy,0 patients had complete response,6 patients had partial response,50 patients had stable disease,and 17 patients had disease progression,ORR was 8.22%,and DCR was76.71%.The ORR of the single agent group and combination group were 7.14%?8.89%while the DCR were 75.00%?77.78%.The difference of ORR(P=1.000)and DCR(P=0.785)between two groups neither reached statistical significance.The change of serum tumor markers CA125 after the treatment negatively correlated with the short-term effect(r_s=-0.396,P=0.031).According to the current data,the changes of serum tumor markers CEA and CA153 after the treatment could not be considered to be correlated with the short-term effect(P=0.315?P=0.494).2.Long-term effect and factors influencing efficacy of apatinib:The median PFS of 73 patients was 113 days(89.744 to 136.256 days).The median PFS was 113days(82.923 to 143.077 days)in the 28 cases single agent apatinib group and 113days(97.226 to 128.774 days)in the 45 cases apatinib combination group.The difference between two groups did not reach statistical significance(P=0.206).Multivariate Cox proportional hazards regression analysis indicated that the treatment-related hypertension and HFS were protective factors while the higher the ECOG score was the risk factor affecting PFS of breast cancer patients.3.Side effects:The treatment-related side effects which were controlled and tolerated well were mild to moderate mostly and ranked as class 1~2.After treatment the effects can be controlled or tolerated.Conclusion(1)Apatinib has a certain therapeutic effect and better survival,controlled side effects and the good tolorance on advanced breast cancer,it is worth the clinical generalization,but the result needs larger sample size to prove.(2)The clinical efficacy and PFS of the two groups did not reach statistical significance(P>0.05),we can choose a treatment comprehensively according to patient's physical condition,illness and willing.(3)The change of serum tumor markers CA125 after the treatment negatively correlated with the short-term effect.The ECOG score?treatment-related hypertension and HFS were independent prognostic factors affecting PFS of breast cancer patients.