Zhongliu Fangzhi Yanjiu (Nov 2020)
Clinical Observation of Apatinib in Treatment of Refractory Advanced Breast Cancer
Abstract
Objective To evaluate the clinical efficacy and safety of apatinib in the treatment of advanced breast cancer(ABC) patients refractory to multiline treatments. Methods We retrospectively analyzed the clinical data of 29 ABC patients after the failure of multi-line treatments. Patients were treated with apatinib 500 mg/d orally. The clinical efficacy and adverse effects were evaluated. Symptomatic treatment and nursing care were given when the adverse effects were ≥grade Ⅲ and apatinib was suspended if not get relieved. When the adverse effects were ≤gradeⅠ, apatinib was administrated with reduced dosage of 250mg/d. Results Among 29 patients, there was no case with complete remission, 11(37.9%) patients with partial remission (PR), 13(44.8%) cases with stable disease (SD) and 5(17.2%) patients with progressive disease (PD). The disease control rate (PR+SD) was 82.8% (24/29). The median progression-free survival time (mPFS) was 126 days. The most common adverse effects were secondary hypertension(27.59%), hand-foot syndrome(20.69%), Secondary proteinuria(17.24%), nausea and fatigue(13.79%), Secondary oral mucositis(17.24%) and diarrhea(10.24%). Most of the side effects were degreeⅠ-Ⅱ. Log-rank univariate analysis showed a mPFS of 267 days for Luminal B(HER2-) ABC patients and 126 days for triple-negative group, compared with 33 days for HER2+ ABC patients (P=0.057). Patients with secondary hypertension or transient proteinuria had significantly longer mPFS than those without these adverse effects (P=0.025, P=0.058). Cox regression analysis identified molecular typing, secondary hypertension and proteinuria as the independent influence factors for mPFS of ABC patients treated with apatinib. Conclusion Apatinib has relatively high DCR and PFS in the treatment of Luminal B (HER2-) and triple-negative MBC patients, and adverse reactions could be controlled.
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