Efficacy And Safety Of Apatinib Treatment For Advanced Solid Tumor:A Meta-Analysis

Background: Tumor angiogenesis plays an important role in the growth of most solid tumors and the migration of tumor cells.Vascular endothelial growth factor(VEGF)and its receptor tyrosine kinase(VEGFR)-mediated signaling cascade pathway is an important pathway of tumor angiogenesis.Apatinib is a kind of small molecule TKIs of VEGFR2,which has been shown to be effective in the treatment of various advanced solid tumors.However,there is still a lack of large sample data to support its clinical efficacy and safety.Objective: This study was aimed to evaluate the efficacy and safety of apatinib in advanced solid tumor by meta-analysis.Materials and methods: A literature search for collecting randomized controlled trials(RCTs)was performed using the Pubmed,Cochrane library,Web of science,Embase,CNKI database.The quality evaluation was carried out according to Cochrane bias risk assessment criteria.Stata12.0software was used to perform the meta-analysis.Efficacy analysis was assessed by disease control rate(DCR),objective response rate(ORR),total survival time(OS),and progression-free survival(PFS),and safety analysis was performed for adverse reactions in apatinib group and control group.Results: Seven clinical studies met the inclusion criteria.Both objective response rates(ORR)and disease control rates(DCR)were significantly improved in Apatinib group compared to the control group(RR=2.18,95%CI 1.30-3.65;RR= 2.09,95%CI 1.21-3.60).The DCR of850 mg qd and 750 mg qd were higher compared to the control group(p<0.05).Apatinib prolongs progression-free survival(PFS)and overall survival(OS).Based on short-term acute adverse reactions of Apatinib,significant differences between groups were found on hypertension(RR=8.38,p<0.05),urine protein(RR=2.66,p<0.05),hand foot syndrome(RR=11.50,p<0.05),and gastrointestinal reaction(diarrhea)(RR=2.63,p=0.02);while no significant differences were found on myelosuppression(RR=1.45,p=0.48),nausea and vomiting(RR=1.00,p=0.99).Conclusion: Apatinib has a certain short-term effect and survival benefit on some malignant solid tumor types:GC,HCC and NSCLC,with controllable adverse effect.