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Efficacy and safety of apatinib combined with chemotherapy for the treatment of advanced gastric cancer in the Chinese population: a systematic review and meta-analysis

Authors Cheng HG, Sun AX, Guo QB, Zhang YC

Received 10 April 2018

Accepted for publication 16 May 2018

Published 11 July 2018 Volume 2018:12 Pages 2173—2183

DOI https://doi.org/10.2147/DDDT.S170678

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Tuo Deng


Honggang Cheng,1 Aixia Sun,2 Qingbo Guo,3 Yucai Zhang4

1Department of Gastroenterological Surgery, Liaocheng People’s Hospital, Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, People’s Republic of China; 2Department of Clinical Laboratory, Liaocheng People’s Hospital, Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, People’s Republic of China; 3Department of Clinical Laboratory, Yidu Central Hospital of Weifang, Qingzhou 262500, Shandong Province, People’s Republic of China; 4Department of Health, Liaocheng People’s Hospital of Taishan Medical University, Liaocheng 252000, Shandong Province, People’s Republic of China

Objective: To systematically evaluate the efficacy and safety of the combination of apatinib targeted therapy and chemotherapy (CT) in the treatment of patients with advanced gastric cancer (GC).
Materials and methods: Clinical trials were extracted from PubMed, the Cochrane Library, Web of Science, EMBASE, CNKI, and the Wanfang database. Outcome measures, including therapeutic efficacy, quality of life (QOL), and adverse events, were extracted and evaluated.
Results: Nineteen trials, including 1,256 advanced GC patients, were included. The results indicated that, compared with CT alone, the combination of apatinib targeted therapy with CT significantly improved the patients’ complete response rate (OR=1.85, 95% CI=1.04–3.28, P=0.04), partial response rate (OR=2.19, 95% CI=1.71–2.80, P<0.00001), overall response (OR=2.57, 95% CI=1.99–3.32, P<0.00001), and disease control rate (OR=3.46, 95% CI=2.57–4.66, P<0.00001). Moreover, the combined therapy exhibited advantages over CT alone in the patients’ QOL including the QOL improved rate (OR=1.77, 95% CI=0.94–3.33, P=0.08) and the Karnofsky performance score (OR=1.77, 95% CI=0.94–3.33, P=0.08). The group that received the combined therapy had higher rates of hypertension (OR=5.75, 95% CI=2.22–14.92, P=0.0003), albuminuria (OR=15.42, 95% CI=5.39–44.10, P<0.00001), and hand–foot syndrome (OR=2.09, 95% CI=1.26–3.48, P=0.004), whereas analyses of other adverse events, such as leucopenia, thrombocytopenia, and neutropenia, did not reveal significant differences (P>0.05).
Conclusion: The combination of apatinib targeted therapy and CT is more effective for GC treatment than CT alone. However, this combined treatment could lead to greater rates of hypertension, albuminuria, and hand–foot syndrome. Therefore, the benefits and risks should be considered before treatment.

Keywords: apatinib, target therapy, chemotherapy, gastric cancer, meta-analysis

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