PMID- 33955301
OWN - NLM
STAT- MEDLINE
DCOM- 20211129
LR  - 20211129
IS  - 1533-0338 (Electronic)
IS  - 1533-0346 (Print)
IS  - 1533-0338 (Linking)
VI  - 20
DP  - 2021 Jan-Dec
TI  - Continuous Low-Dose Apatinib Combined With WBRT Significantly Reduces Peritumoral 
      Edema and Enhances the Efficacy of Symptomatic Multiple Brain Metastases in 
      NSCLC.
PG  - 15330338211011968
LID - 10.1177/15330338211011968 [doi]
LID - 15330338211011968
AB  - BACKGROUND: Symptomatic multiple brain metastases with peritumoral brain edema 
      (PTBE) occur in non-small cell lung cancer patients (NSCLC) who are without 
      driver mutations or are resistant to epidermal growth factor tyrosine kinase 
      (EGFR-TKI) are often associated with an unfavorable prognosis. Whole brain 
      radiation therapy (WBRT) which comes with many complications and unsatisfactory 
      effects, is the only option for the treatment. Previous studies have shown that 
      bevacizumab can reduce the volume of PTBE and improve efficiency of radiotherapy. 
      This study evaluated the effects and safety of apatinib combined with WBRT in 
      NSCLC patients with symptomatic multiple brain metastases and PTBE. METHODS: We 
      performed a retrospective review of 34 patients with symptomatic multiple brain 
      metastases from NSCLC (number >4, and at least 1 measurable brain metastasis 
      lesion with cerebral edema). Intracranial objective response rate (IORR), 
      peritumoral edema and intracranial tumor volumetric measurement, Karnofsky 
      performance status (KPS) and adverse events (AEs) were evaluated. Median 
      intracranial progression-free survival (mIPFS) and median overall survival (mOS) 
      were also analyzed. RESULTS: Thirteen cases received apatinib (125 mg or 250 mg, 
      QD, oral) combined with WBRT and 21 cases received chemotherapy combined with 
      WBRT were inclued. Apatinib combination group can better reduce the volume of 
      intracranial tumors and PTBE and total steroid dosage used. It was associated 
      with a better IORR (84.6% vs 47.6%, P = 0.067), longer mIPFS (6.97 vs 4.77months; 
      P = 0.014). There was no significant difference in mOS(7.70 vs 6.67 months; P = 
      0.14) between the 2 groups. The most common adverse events of apatinib 
      combination WBRT included grade 1/2 nausea (4/13), fatigue (3/13), hypertension 
      (2/13) and white blood cell decrease (2/13). No grade 3/4 AEs were observed. 
      CONCLUSION: Apatinib plus WBRT is well tolerated and may be a potential choice 
      for relapsed or drug-resistant advanced NSCLC patients with symptomatic multiple 
      brain metastases and PTBE.
FAU - Ren, Yue
AU  - Ren Y
AD  - 74655North Sichuan Medical College, Nanchong, Sichuan, China.
AD  - Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan, 
      China.
FAU - Wang, Shan-Bing
AU  - Wang SB
AD  - Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan, 
      China.
FAU - Zhou, Lin
AU  - Zhou L
AD  - West China Hospital, 34753Sichuan University, Cheng du, China.
FAU - Liu, Si-Qiao
AU  - Liu SQ
AD  - 12599University of Electronic Science and Technology of China, Sichuan, China.
FAU - Du, Lei-Ya
AU  - Du LY
AD  - Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan, 
      China.
FAU - Li, Ting
AU  - Li T
AD  - Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan, 
      China.
FAU - Jiang, Mao-Qiong
AU  - Jiang MQ
AD  - Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan, 
      China.
FAU - Lei, Kai-Jian
AU  - Lei KJ
AD  - Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan, 
      China.
FAU - Tan, Bang-Xian
AU  - Tan BX
AD  - 74655North Sichuan Medical College, Nanchong, Sichuan, China.
FAU - Jia, Yu-Ming
AU  - Jia YM
AUID- ORCID: 0000-0002-3934-9133
AD  - Department of Oncology, The Second People's Hospital of Yibin, Yibin, Sichuan, 
      China.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Technol Cancer Res Treat
JT  - Technology in cancer research & treatment
JID - 101140941
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Pyridines)
RN  - 5S371K6132 (apatinib)
SB  - IM
MH  - Aged
MH  - Brain Neoplasms/pathology/*therapy
MH  - Carcinoma, Non-Small-Cell Lung/pathology/*therapy
MH  - Chemoradiotherapy/*mortality
MH  - Cranial Irradiation/*methods
MH  - Dose-Response Relationship, Drug
MH  - Edema/*prevention & control
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung Neoplasms/pathology/*therapy
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Protein Kinase Inhibitors/*therapeutic use
MH  - Pyridines/*therapeutic use
MH  - Retrospective Studies
MH  - Survival Rate
PMC - PMC8111549
OTO - NOTNLM
OT  - apatinib
OT  - brain metastases
OT  - non-small cell lung cancer
OT  - peritumoral brain edema
OT  - radiation therapy
OT  - whole brain radiotherapy
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/05/07 06:00
MHDA- 2021/11/30 06:00
PMCR- 2021/05/06
CRDT- 2021/05/06 08:46
PHST- 2021/05/06 08:46 [entrez]
PHST- 2021/05/07 06:00 [pubmed]
PHST- 2021/11/30 06:00 [medline]
PHST- 2021/05/06 00:00 [pmc-release]
AID - 10.1177_15330338211011968 [pii]
AID - 10.1177/15330338211011968 [doi]
PST - ppublish
SO  - Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211011968. doi: 
      10.1177/15330338211011968.