Apatinib is an oral inhibitor of the vascular endothelial growth factor receptor (VEGFR)-2. There is currently no standard treatment for patients with gynecologic cancer who failed from ≥2 lines of chemotherapy. The purpose of this study is to evaluate the benefits and adverse events of apatinib in the treatment of patients with advanced cervical and ovarian cancer who failed from ≥2 lines of chemotherapy.
Patients with advanced cervical and ovarian cancer received at least two lines of prior chemotherapy before being treated with apatinib were retrospectively reviewed between April 2015 and January 2017. All included patients received continuous apatinib treatment until disease progression, death, or intolerable toxicity. Prognosis and toxicities were evaluated by the Kaplan-Meier method and according to NCI-CTC 3.0, respectively.
Twenty-six patients were eligible (cervical cancer, n = 12 (46.2%); ovarian cancer, n = 14 (53.8%)). After apatinib dose adjustment, 14 patients (53.8%) received 500 mg/day, 8 received 250 mg/day, 3 received 425 mg/day, and one received 675 mg/day. The median progression-free survival (PFS) of cervical and ovarian cancer was 8 months (95% confidence interval (CI): 3.83-12.17) and 4 months (95%CI:1.57-6.44), respectively. The objective response rates in cervical cancer and ovarian cancer were 50% (n = 6/12) and 50% (n = 7/14), respectively. The disease control rates were 100% (n = 12/12) for cervical cancer and 71.4% (n = 10/14) for ovarian cancer. No complete response was observed. The toxicities associated with apatinib were generally acceptable: eight patients (30.8%) developed grade 3/4 toxicity. The most common adverse events were hypertension (n = 17; 65.4%), hand-foot syndrome (n = 24, 92.3%), and mouth mucositis (n = 20, 76.9%).
Apatinib monotherapy could be a promising and tolerable treatment for patients with advanced/recurrent cervical and ovarian cancer who failed from two or more lines of chemotherapy.
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All authors have declared no conflicts of interest.