The Efficacy of Apatinib Treatment for Advanced Ovarian Cancer After Second-Line Chemotherapy Failure
Ovarian carcinoma has the highest mortality rate among gynecologic malignancies, due in part to the primary drug resistance and multidrug resistance that represent major clinical obstacles to treatment.1 Apatinib is a small-molecule tyrosine kinase inhibitor independently developed in China that mainly functions by competitively blocking the binding of VEGF with VEGFR-2 and preventing the autophosphorylation of VEGFR-2. Antitumor effects are thereby elicited by preventing VEGF-mediated endothelial cell proliferation and migration, and reducing tumor angiogenesis. In this prospective, open-label, single-arm clinical trial, Sun and colleagues evaluated the efficacy and safety of apatinib mesylate as treatment after failure of second-line chemotherapy in patients with advanced epithelial ovarian cancer.2
Of 17 evaluable patients who received oral apatinib for 3 treatment cycles (each cycle included 500 mg or 250 mg apatinib once daily for 28 days), 6 (35.3%) and 2 (11.8%) patients achieved partial response and stable disease, respectively. The objective response rate (ORR) and disease control rate (DCR) were 35.3% and 47.1%, respectively. Efficacy signals were not significantly different between groups receiving initial dosages of 500 mg (ORR, 30%; DCR, 30%) and 250 mg (ORR, 42.8%; DCR, 71.4%). The median progression-free survival was 2.2 months (95% confidence interval [CI], 1.0-8.9 months) and the median overall survival was 6.3 months (95% CI, 1.5-12.8 months). The most common adverse events reported were hypertension (70.6%), hand-foot syndrome (52.9%), and oral mucosa damage (35.3%).
The results of this study suggest that oral apatinib treatment is efficacious and well-tolerated in patients with advanced epithelial ovarian cancer who have failed second-line chemotherapy.
- Norouzi-Barough L, et al. J Cell Physiol. 2018;233(6):4546-4562.
- Sun S, et al. ESMO 2018. Abstract 974P.