Apatinib treatment combined with chemotherapy for advanced epithelial ovarian cancer: a case report

Abstract

Apatinib is a novel oral tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2, which has been proved by clinical trials to be effective and safe for patients with chemotherapy-refractory gastric cancer. To date, there is no study or case report on apatinib treatment for patients with ovarian cancer. Here, we present the case of a 50-year-old Chinese woman with advanced ovarian cancer, who received apatinib at a daily dose of 500 mg for 28 days per cycle after failure of fourth-line chemotherapy. Favorable oncologic outcome was achieved in this case after treatment with apatinib. The patient's progression-free survival is now 11.3 months, and she is taking apatinib and capecitabine as maintenance treatment. The common side effect of apatinib was fatigue; however, the toxicity of apatinib was controllable and tolerable. Thus, apatinib may be an option for chemotherapy-refractory advanced epithelial ovarian cancer, but this still warrants further investigation.

Keywords: advanced epithelial ovarian cancer; angiogenesis inhibitor; apatinib; chemotherapy; targeted therapy.

Figure 1

Pelvic CT shows the lymph node metastasis. (A) Before therapy (August 17, 2015). (B) Before therapy (October 22, 2015), the lymph node was bigger than 2 months earlier. (C) After 3 months of apatinib treatment (March 7, 2016), the lymph node was smaller than 4 months earlier. (D) After 9 months of apatinib treatment (August 30, 2016), the lymph node was smaller than 5 months earlier. Red arrows indicate the lymph node metastasis. Abbreviation: CT, computed tomography.

Figure 2

Pelvic CT shows the metastatic mass in front of the rectum. (A) Before therapy (August 17, 2015). (B) Before therapy (October 22, 2015), the mass was bigger than 2 months earlier (C) After 3 months of apatinib treatment (March 7, 2016), the mass was smaller than 4 months earlier. (D) After 9 months of apatinib treatment (August 30, 2016), the mass was smaller than 5 months earlier. Red arrows indicate the metastatic mass in front of the rectum. Abbreviation: CT, computed tomography.

Figure 3

The serum CA125 level during the treatment with apatinib. Abbreviation: CA125, cancer antigen 125.