PMID- 30170427
OWN - NLM
STAT- MEDLINE
DCOM- 20180917
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 35
DP  - 2018 Aug
TI  - Efficacy and safety of apatinib in patients with advanced nonsmall cell lung 
      cancer that failed prior chemotherapy or EGFR-TKIs: A pooled analysis.
PG  - e12083
LID - 10.1097/MD.0000000000012083 [doi]
LID - e12083
AB  - BACKGROUND: Apatinib is a tyrosine kinase inhibitor (TKI) that selectively 
      inhibits the vascular endothelial growth factor receptor-2. A weighted pooled 
      analysis was performed to evaluate the clinical outcome, efficacy, and toxicity 
      of apatinib in patients with advanced nonsmall cell lung cancer (NSCLC) that 
      failed prior treatment with chemotherapy or epidermal growth factor receptor-TKIs 
      (EGFR-TKIs). METHODS: The literature published in PubMed, Embase, and Cochrane 
      Library databases was searched (from inception to November 30, 2017) for eligible 
      trials using the following search terms: apatinib AND (lung cancer OR NSCLC). 
      Meeting abstracts were also reviewed to identify appropriate studies. Inclusion 
      criteria were as follows: prospective or retrospective studies that evaluated 
      efficacy and/or safety of apatinib in patients with advanced NSCLC that failed 
      prior chemotherapy or EGFR-TKIs; primary outcome included one of these endpoints, 
      progression-free survival (PFS), overall survival (OS), objective response rate 
      (ORR), disease control rate (DCR), or adverse events (AEs); English language; and 
      number of cases in the study >/=10 cases. RESULTS: A total of 457 patients with 
      advanced NSCLC were treated with apatinib in 14 studies (10 retrospective and 4 
      prospective studies) and were included in this pooled analysis. The pooled median 
      PFS was 4.77 months [95% confidence interval (CI), 4.11-5.00] in all groups, 4.80 
      months (95% CI, 4.65-4.95) in the 750 mg apatinib (high-dose) group, and 3.88 
      months (95% CI, 3.11-4.65) in the 250 to 500 mg apatinib (low-dose) group. Median 
      PFS stratified by single apatinib therapy or apatinib combined with continuous 
      EGFR-TKIs was 4.76 months (95% CI, 3.66-5.06) and 5.20 months (95% CI, 
      3.66-6.74), respectively. The pooled median OS, ORR, and DCR values were 6.85 
      months, 18%, and 72%, respectively; pooled median ORR and DCR were 15% and 72% in 
      the 750 mg apatinib group versus 20% and 72% in the 250 to 500 mg apatinib group. 
      ORR and DCR stratified by therapeutic regimens were 14% and 70% for single-agent 
      apatinib, 29% and 88% for apatinib combined with continuous EGFR-TKIs, and 26% 
      and 63% for apatinib combined with chemotherapy, respectively. The pooled AE 
      rates of grade 3/4 were hypertension (7%), proteinuria (3%), hand-foot-skin 
      reaction (6%), fatigue (4%), decreased appetite (1.1%), oral mucositis (3%), and 
      thrombocytopenia (3%). CONCLUSION: Apatinib has promising antitumor activity and 
      manageable toxicity profile in patients with advanced NSCLC that failed prior 
      chemotherapy or EGFR-TKIs. This result needs to be confirmed through the ongoing 
      Phase III clinical trial.
FAU - Ma, Jie-Tao
AU  - Ma JT
AD  - Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 
      China.
FAU - Sun, Jing
AU  - Sun J
FAU - Sun, Li
AU  - Sun L
FAU - Zhang, Shu-Ling
AU  - Zhang SL
FAU - Huang, Le-Tian
AU  - Huang LT
FAU - Han, Cheng-Bo
AU  - Han CB
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Pyridines)
RN  - 5S371K6132 (apatinib)
RN  - EC 2.7.10.1 (Vascular Endothelial Growth Factor Receptor-2)
SB  - IM
MH  - Antineoplastic Agents/adverse effects/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/mortality
MH  - Disease-Free Survival
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/mortality
MH  - Male
MH  - Protein Kinase Inhibitors/administration & dosage/adverse effects/*therapeutic 
      use
MH  - Pyridines/administration & dosage/adverse effects/*therapeutic use
MH  - Vascular Endothelial Growth Factor Receptor-2/antagonists & inhibitors
PMC - PMC6392903
COIS- The authors have no conflicts of interest to declare.
EDAT- 2018/09/02 06:00
MHDA- 2018/09/18 06:00
PMCR- 2018/08/21
CRDT- 2018/09/02 06:00
PHST- 2018/09/02 06:00 [entrez]
PHST- 2018/09/02 06:00 [pubmed]
PHST- 2018/09/18 06:00 [medline]
PHST- 2018/08/21 00:00 [pmc-release]
AID - 00005792-201808310-00059 [pii]
AID - MD-D-18-01891 [pii]
AID - 10.1097/MD.0000000000012083 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Aug;97(35):e12083. doi: 10.1097/MD.0000000000012083.