APATINIB FOR GASTRIC CANCER

NEW YORK (Reuters Health) Aug 07 - Apatinib continues to show promise for refractory advanced metastatic gastric cancer (mGC).

In a phase II trial, apatinib improved progression-free and overall survival in patients with mGC who had failed at least two chemotherapy regimens.

Results with the tyrosine kinase inhibitor, which selectively inhibits vascular endothelial growth factor (VEGF) receptor 2, were reported online August 5 in the Journal of Clinical Oncology by Dr. Jin Li from Fudan University Shanghai Cancer Center and colleagues.

They point out that when second-line therapy for mGC fails, there are no options that clearly confer a survival benefit.

To test the effects of apatinib, the study team randomly assigned 144 patients who experienced treatment failure with at least two chemotherapeutic regimens to placebo, apatinib 850 mg once daily, or apatinib 425 mg twice daily.

Apatinib-treated patients lived longer than placebo-treated patients.

Median overall survival was 2.50 months with placebo, vs 4.83 and 4.27 months with apatinib 850 and 425 mg daily, respectively.

The median progression-free survival times were also longer with apatinib (3.67 and 3.20 months with 850 and 425 mg daily vs 1.40 months with placebo).

These differences in PFS and OS with apatinib and placebo were statistically significant, the investigators say.

There were no significant differences between the three treatment arms with regard to quality of life scores. "Toxicities were tolerable or could be clinically managed," the authors say. "The most common grade 3 to 4 adverse events were hand-foot syndrome and hypertension. Hematologic toxicities were moderate, and grade 3 to 4 hematologic toxicities were rare."

They say a "growing" number of patients with mGC are being offered second-line chemotherapy, and there is "an increasing need" for further active treatments beyond second-line chemotherapy. Apatinib is a promising option, they say.

A phase III study of apatinib in mGC is ongoing. The details can be found here:http://1.usa.gov/15NPLRT

The study was supported by Jiangsu Hengrui Medicine, Lianyungang, China. The investigators could not be reached for comment. The paper states no potential conflicts of interest for the authors.

SOURCE: http://bit.ly/13jUJCU

J Clin Oncol 2013.