Efficacy And Safety Assessment Of Apatinib In Patients With Recurrent Epithelial Ovarian Cancer:A Meta-analysis

Objective: To evaluate the efficacy of apatinib in the treatment of recurrent epithelial ovarian cancer and further explore the adverse events and safety of apatinib in the treatment of ovarian cancer.Methods: The Englisih databases including Pubmad,Medline,Cochrane Library,Embase and web of science and the Chinese databases such as CNKI,VIP,Wanfang,and CBM were searched for the randomized controlled trials published as of January 1,2020,in which apanitinb monotherapy or combined therapy was compared to chemotherapy in patients with ruccurent epithelial ovarian cancer.The search terms were ovarian cancer,recurant epithelial ovarian cancer and apatinib.Two investigators independently assessed the articles and extracted their data according to the research inclusion criteria and exclusion criteria.The Cochrane Handbook 5.1.0 was used to systematicly evaluate the quality of the inclusion tests.Finally,the relative risk(RR)was analsyzed using stata 14 software for objective response rate(ORR),disease control rate(DCR)and the incidence of adverse events.Results: A total of 11 RCTs were included for this meta-analysis,which divided into test group and control group,containing 317 and 353 cases seperatly,totally 670 cases.Meta-analysis showed that comparing with control group,apatinib improved the ORR(RR=1.77,95%CI:1.50-2.09,P=0.000)and DCR(RR=1.31,95%CI:1.19-1.43,P=0.000).As for the occurance of adverse events,apatinib increaced the risk of hypertension(RR=3.68,95%CI:2.43-5.56,P=0.000)and hand-foot syndrom(RR=4.55,95%CI:2.67-7.74,P=0.000).There was no significant difference between test and control group in the accidence rates about gastrointestinal reactions(RR=0.93,95%CI:0.76-1.14,P=0.469),liver and kidney function damage(RR=1.02,95%CI:0.72-1.45,P=0.919),leukopenia(RR=0.90,95%CI:0.71-1.13,P=0.359)and thrombocytopenia(RR=0.94,95%CI:0.46-1.93,P=0.864).Conclusions: Apatinib monotherapy or combination chemotherapy can improve the objective response rate and disease control rate of recurrent epithelial ovarian cancer.The main adverse reactions are hypertension,hand-foot syndrome,and most of them could be controlled by the symptomatic treatment.Apatinib can be a safety and effective strategy for the treatment of recurrent epithelial ovarian cancer.