[1]赵 珅 范南峰 李 惠 刘 捷 俞嘉青 林榕波.阿帕替尼联合紫杉醇化疗方案治疗紫杉醇耐药的晚期胃癌的临床研究[J].福建医药杂志,2020,42(01):16-19.
　ZHAO Shen,FAN Nanfeng,LI Hui,et al.Clinical study of apatinib combined with paclitaxel chemotherapy in the treatment of paclitaxel-resistant advanced gastric cancer[J].FUJIAN MEDICAL JOURNAL,2020,42(01):16-19.
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阿帕替尼联合紫杉醇化疗方案治疗紫杉醇耐药的晚期胃癌的临床研究()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
42
期数:
2020年01期
页码:
16-19
栏目:
临床研究
出版日期:
2020-03-30

文章信息/Info

Title:
Clinical study of apatinib combined with paclitaxel chemotherapy in the treatment of paclitaxel-resistant advanced gastric cancer
文章编号:
1002-2600(2020)01-0016-04
作者:
赵 珅 范南峰 李 惠 刘 捷 俞嘉青 林榕波1
福建省肿瘤医院 福建医科大学附属肿瘤医院腹部肿瘤科(福州 350014)
Author(s):
ZHAO Shen;  FAN Nanfeng;  LI Hui;  LIU Jie;  YU Jiaqing;  LIN Rongbo.
Department of Abdominal Oncology, Fujian Provincial Cancer Hospital, Fuzhou, Fujian 350014,China
关键词:
胃癌;  阿帕替尼;  耐药性逆转;  含紫杉醇化疗
Keywords:
gastric cancer;  apatinib;  reversal of multidrug resistance;  paclitaxel-contained regimens
分类号:
R735.2
文献标志码:
A
摘要:
目的 评价阿帕替尼联合紫杉醇化疗方案在紫杉醇耐药的晚期胃癌患者中的疗效及安全性。方法 选取7例紫杉醇耐药的晚期胃癌患者进行回顾性研究,其中4例给予850 mg阿帕替尼靶向治疗同时联合单药紫杉醇化疗,3例给予850 mg阿帕替尼靶向治疗联合紫杉醇+奥沙利铂+氟尿嘧啶(POF)方案全身化疗。结果 在到达研究截止时间时,6位患者死亡,中位无进展生存期(PFS)4.4个月[95%可信区间:(2.1,6.7)个月]; 中位总生存期(OS)6.9个月[95%可信区间:(1.8,12.0)个月]。7例患者中,6例行肿瘤反应的评估,其中2例患者部分缓解(PR),4例患者疾病稳定(SD),客观反应率28.6%[95%可信区间:(8.2%,64.1%)],疾病控制率87.5%[95%可信区间:(48.7%,97.4%)]。大多数的不良反应轻或可控制。结论 对于紫杉醇耐药的晚期胃癌患者,阿帕替尼联合含紫杉醇的化疗方案,可延长患者PFS并获得较好的OS,不良反应均为可耐受的。因此,这一方案有望成为紫杉醇耐药晚期胃癌患者的治疗选择。
Abstract:
Objective The present study aimed to investigate the efficacy and safety of apatinib combined with paclitaxel-contained regimens in patients with advanced gastric cancer who experienced paclitaxel-contained treatment failure.Methods We retrospectively reviewed the medical records of seven patients with heavily pretreated advanced gastric cancer.These patients had progressive disease after prior treatment including paclitaxel-contained treatment.Apatinib was given to patients in combination with POF regimens or paclitaxel alone.Four of seven patients were treated with apatinib daily at initial dose of 850 mg combined with paclitaxel alone and three patients received apatinib combined with POF.Results At the time of data cutoff, six patients died, with median progression-free survival(PFS)of 4.4 months [95CI%:(2.1,6.7)months], and median overall survival(OS)of 6.9 months [95CI%:(1.8,12.0)months].Six of seven patients were evaluable for tumor response evaluation: two patients achieved partial remission(PR)and four patients achieved stable disease(SD), with an objective response rate of 28.6%[95%CI:(8.2%,64.1%)] and a disease control rate of 87.5%[95%CI:(48.7%,97.4%)].Most adverse events were mild and manageable.Conclusion The combination therapy of apatinib with paclitaxel-contained therapy could be a treatment option for patients with advanced or metastatic gastric cancer who experience paclitaxel-based treatment failure, with acceptable toxicity.

参考文献/References:

[1] Torre L A, Bray F, Siegel R L, et al.Global cancer statistics, 2012 [J]. CA Cancer J Clin, 2015, 65(2): 87-108.
[2] Van Cutsem E, Haller D, Ohtsu A.The role of chemotherapy in the current treatment of gastric cancer [J]. Gastric Cancer, 2002,5(Suppl 1):17-22.
[3] Lin R, Fan N, Wu G, et al.A phase 2 study of fluorouracil/leucovorin in combination with paclitaxel and oxaliplatin as a salvage treatment in patients with refractory or relapsed advanced gastric cancer [J]. J Chemother, 2015, 27(1): 52-56.
[4] Vasan N,Baselga J, Hyman D M.A view on drug resistance in cancer[J]. Nature,2019,575(7782): 299-309.
[5] Kathawala R J, Gupta P, Ashby C R Jr, et al.The modulation of ABC transporter-mediated multidrug resistance in cancer: a review of the past decade [J]. Drug Resist Updat, 2015,18:1-17.
[6] Chen Y,Scully M,Petralia G,et al.Binding and inhibition of drug transport proteins by heparin: a potential drug transporter modulator capable of reducing multidrug resistance in human cancer cells[J]. Cancer biology & therapy, 2014, 15(1):135-145.
[7] Wang J Q,Wang B,Lei Z N, et al.Derivative of 5-cyano-6-phenylpyrimidin antagonizes ABCB1- and ABCG2-mediated multidrug resistance[J].Eur J Pharmacol,2019,863,172611.
[8] Li J, Zhao X, Chen L, et al.Safety and pharmacokinetics of novel selective vascular endothelial growth factor receptor-2 inhibitor YN968D1 in patients with advanced malignancies [J]. BMC Cancer, 2010,10:529.
[9] Tong X Z, Wang F, Liang S, et al.Apatinib(YN968D1)enhances the efficacy of conventional chemotherapeutical drugs in side population cells and ABCB1-over expressing leukemia cells [J]. Biochemical pharmacology,2012, 83(5): 586-597.
[10] Li J, Qin S, Xu J, et al.Randomized, Double-Blind, Placebo-Controlled Phase Ⅲ Trial of Apatinib in Patients With Chemotherapy-Refractory Advanced or Metastatic Adenocarcinoma of the Stomach or Gastroesophageal Junction[J]. J Clin Oncol, 2016, 34(13): 1448-1454.
[11] Mi Y J, Liang Y J, Huang H B, et al.Apatinib(YN968D1)reverses multidrug resistance by inhibiting the efflux function of multiple ATP-binding cassette transporters [J]. Cancer Res, 2010, 70(20): 7981-7991.
[12] Li J, Qin S, Xu J, et al.Randomized, double-blind, placebo-controlled phase iii trial of apatinib in patients with chemotherapy-refractory advanced or metastatic adenocarcinoma of the stomach or gastroesophageal Junction[J]. J Clin Oncol,2016, 34(13): 1448-1454.
[13] Zhu J, Li X,Xie C H, et al.Apatinib, a New Small Molecular VEGFR2 inhibitor, suppresses the activity of lung cancer stem cells[J]. J Thorac Oncol,2017, 12(suppl 1): s1279.
[14] Yu M, Gao Z, Dai X, et al.Population pharmacokinetic and covariate analysis of apatinib, an oral tyrosine kinase inhibitor, in healthy volunteers and patients with solid tumors[J]. Clin Pharmacokinet, 2017, 56(1): 65-76.

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备注/Memo

备注/Memo:
基金项目:福建省医学创新课题(2016-CX-12)1 通信作者,Email:rongbo_lin@163.com
更新日期/Last Update: 2020-03-30