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Concurrent apatinib and docetaxel vs apatinib monotherapy as third- or subsequent-line therapy for advanced gastric adenocarcinoma: a retrospective study

Authors Lin H, Han D, Fu G, Liu C, Wang L, Han S, Liu B, Yu J

Received 7 November 2018

Accepted for publication 28 January 2019

Published 28 February 2019 Volume 2019:12 Pages 1681—1689

DOI https://doi.org/10.2147/OTT.S193801

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Dr Sanjay Singh


Haimin Lin,1,2,* Dali Han,1,* Guobin Fu,3 Chengxin Liu,1 Lili Wang,4 Shumei Han,5 Bo Liu,5 Jinming Yu1

1Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, China; 2School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong 250200, China; 3Department of Medical Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, China; 4Department of Bone and Soft Tumor, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, China; 5Department of Medical Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong 250117, China

*These authors contributed equally to this work

Purpose: The aim of this study was to assess the efficacy and safety of concurrent apatinib and docetaxel therapy vs apatinib monotherapy as third- or subsequent-line treatment for advanced gastric adenocarcinoma (GAC).
Methods: Patients, who had received apatinib with or without docetaxel as third or more line therapy for advanced GAC, were retrospectively reviewed. Propensity score matching (PSM) analysis was performed to minimize the potential confounding bias. Kaplan–Meier curve and log-rank test were used to analyze the survival. Prognostic factors were estimated by Cox regression. Adverse events (AEs) were evaluated using CTCAE 4.0.
Results: Thirty-four patients received concurrent therapy, whereas 31 received monotherapy. The median progression-free survival (PFS) and overall survival (OS) in monotherapy and con-therapy groups were 2.5 and 4 months (P=0.002), 3.3 and 6 months (P=0.004), respectively. After PSM, the median PFS and OS in the con-therapy group were also superior to the monotherapy group (P=0.004 and P=0.017). Cox regression suggested that Eastern Cooperative Oncology Group performance status (ECOG PS; HR =2.437, 95% CI: 1.349–4.404, P=0.003), CA199 (HR =1.001, 95% CI: 1.000–1.002, P=0.016), and treatment options (HR =0.388, 95% CI: 0.222–0.679, P=0.001) had significant effects on OS. Grade 3/4 toxicities in the monotherapy and con-therapy groups were as follows: leukopenia (0% vs 8.8%), neutropenia (3.2% vs 2.9%), anemia (9.8% vs 8.8%), thrombocytopenia (6.4% vs 2.9%), proteinuria (3.2% vs 2.9%), aminotransferase (0% vs 11.8%), hyperbilirubinemia (9.8% vs 5.9%), hypertension (9.8% vs 5.9%), hand–foot syndrome (3.2% vs 8.8%), nausea and vomiting (0% vs 11.8%), diarrhea (0% vs 5.9%), and fatigue (6.5% vs 2.9%).
Conclusion: Patients with advanced GAC benefit more from concurrent apatinib and docetaxel therapy than apatinib monotherapy.

Keywords: propensity score matching, progression-free survival, overall survival

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