Apatinib combined with SOX regimen for conversion therapy in advanced gastric cancer patients: a retrospective cohort study

by Selleckchem | May 02 2023

Background: Recently, many studies have shown that the progress of conversion therapy can provide surgical opportunities for patients with advanced gastric cancer (GC) and bring survival benefits. However, the results of the current study show that the regimen used in conversion therapy is still controversial. Apatinib, as the standard third-line treatment for GC, has an inconclusive status in conversion therapy.

Methods: This study retrospectively analyzed GC patients admitted to Zhejiang Provincial People's Hospital from June 2016 to November 2019. All patients were pathologically diagnosed, had unresectable factors, and received SOX regimen with or without apatinib as conversion therapy.

Results: A total of 50 patients were enrolled in the study. Altogether 33 patients (66%) received conversion surgery and 17 patients (34%) received conversion therapy without surgery. The median progression-free survival (PFS) between surgery group and non-surgery group were 21.0 versus 4.0 months (p < 0.0001), and the median overall survival (OS) were 29.0 versus 14.0 months (p < 0.0001). In conversion surgery group, 16 patients (16/33) were treated with SOX plus apatinib, and the R0 resection rate was 81.3%; 17 patients (17/33) were treated with SOX regimen along, and the R0 resection rate was 41.2% (p = 0.032). The PFS in the SOX combined with apatinib group was significantly longer than that of SOX group (25.5 versus 16 months, p = 0.045), and the median OS were 34.0 versus 23.0 months (p = 0.048). The addition of apatinib did not increase the incidence of serious adverse reactions throughout the preoperative therapy period.

Conclusions: Patients with advanced inoperable gastric cancer could benefit probably from conversion chemotherapy and subsequence conversion surgery. Apatinib-targeted therapy combined with SOX chemotherapy may be a safe and feasible option for conversion therapy.

Comments：

This study retrospectively analyzed the use of conversion therapy in patients with advanced gastric cancer who received the SOX regimen with or without apatinib. The results showed that conversion surgery had a significant survival benefit compared to non-surgery conversion therapy, with a median PFS of 21.0 versus 4.0 months and a median OS of 29.0 versus 14.0 months, respectively.

Among the patients who received conversion surgery, those treated with SOX plus apatinib had a higher R0 resection rate compared to those treated with SOX alone (81.3% versus 41.2%, p=0.032). The addition of apatinib to SOX chemotherapy also led to a longer median PFS (25.5 versus 16 months, p=0.045) and median OS (34.0 versus 23.0 months, p=0.048), without an increased incidence of serious adverse reactions.

These findings suggest that conversion chemotherapy followed by surgery may provide survival benefits for patients with advanced inoperable gastric cancer, and apatinib-targeted therapy combined with SOX chemotherapy may be a safe and feasible option for conversion therapy. However, further studies are needed to confirm these results and optimize the regimen used in conversion therapy.