Objectives: Despite recent advances in the treatment of advanced ovarian cancer, drug selection after second-line chemotherapy has not been well studied. In this study, we retrospectively evaluated the effect and safety of apatinib as monotherapy or in combination with chemotherapy for the treatment of advanced ovarian cancer after second-line treatment.
Methods: We reviewed the medical records of patients from April 2016 to October 2018 with advanced ovarian cancer who received apatinib after failed second-line chemotherapy. Overall survival (OS) and progression-free survival (PFS) were calculated by the Kaplan–Meier method. Response rate (RR) and disease control rate (DCR) were evaluated using radiologic reports according to RECIST 1.1 criteria. Treatment-related adverse events were evaluated based on NCI-CTC version 4.0.
Results: Study concerned 22 evaluated cases; of them, 13 patients received apatinib combined with chemotherapy and 9 patients received apatinib monotherapy. The median PFS was 8.2 months (9.7 months in combined group and 4.4 months in monotherapy group, P value was 0.21). The median OS was 13.1 months (13.6 months in combined group and 11.6 months in monotherapy group, P value was 0.45). The RR was 20% and DCR was 85% (combined group: RR 33.3%, DCR 100%, monotherapy group: RR 0%, DCR 62.5%). The main side effect was hypertension (9/22), proteinuria (7/22), oral mucositis (5/22), hand and foot syndrome (6/22%), leukopenia (5/22), etc.
Conclusion: Apatinib showed good efficacy and safety for advanced ovarian cancer patients whether used alone or in combination with chemotherapy. In the meanwhile, this study is limited by the small cases number. Therefore, further research is needed to provide more data and ultimately apply it to guide clinical practice.
Keywords: apatinib, chemotherapy, ovarian cancer, efficacy and safety