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. 2018 Jul 19:11:4149-4158.
doi: 10.2147/OTT.S157466. eCollection 2018.

Efficacy and safety assessment of apatinib in patients with advanced gastric cancer: a meta-analysis

Jianxin Chen  1 , Junhui Wang  2
Affiliations

Efficacy and safety assessment of apatinib in patients with advanced gastric cancer: a meta-analysis

Jianxin Chen et al. Onco Targets Ther. .

Abstract

Aim: This meta-analysis was performed to evaluate the efficacy and safety of apatinib in patients with advanced gastric cancer (AGC).

Methods: After evaluating the inclusion and exclusion criteria, the data of eligible randomized clinical trials (RCTs) were extracted. Outcomes including objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were analyzed in the meta-analysis.

Results: Data of 1,069 patients from 13 RCTs were statistically analyzed. Pooled odds ratio (OR) for ORR and DCR was found to be 0.46 (95% confidence interval [CI]: 0.33, 0.64; P<0.00001) and 0.23 (95% CI: 0.15, 0.36; P<0.00001), respectively. Compared with placebo, apatinib showed statistical significance in AEs at any grade, including leucopenia, neutropenia, thrombocytopenia, diarrhea, hypertension, proteinuria, hand-foot syndrome, and fatigue (all P<0.05).

Conclusion: The results of our meta-analysis revealed that apatinib shows short-term efficacy over no-apatinib regimens or placebo regardless of its use as first- or second-line chemotherapy or for further treatment in patients with AGC accompanied with apparent AEs of any grade.

Keywords: adverse events; disease control rate; objective response rate.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study selection procedure with PRISMA flow diagram. Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RCTs, randomized controlled trials.
Figure 2
Figure 2
Forest plot of ORR (A) and DCR (B) between apatinib-alone or apatinib-based regimens and no-apatinib groups. Abbreviations: CI, confidence interval; DCR, disease control rate; M–H, Mantel–Haenzel; ORR, objective response rate.
Figure 3
Figure 3
Forest plot of hematological toxicity (A), digestive events (B), and general events (C1 and C2) between apatinib-alone or apatinib-based regimens and no-apatinib groups. Abbreviations: CI, confidence interval; M–H, Mantel–Haenzel.
Figure 3
Figure 3
Forest plot of hematological toxicity (A), digestive events (B), and general events (C1 and C2) between apatinib-alone or apatinib-based regimens and no-apatinib groups. Abbreviations: CI, confidence interval; M–H, Mantel–Haenzel.
Figure 3
Figure 3
Forest plot of hematological toxicity (A), digestive events (B), and general events (C1 and C2) between apatinib-alone or apatinib-based regimens and no-apatinib groups. Abbreviations: CI, confidence interval; M–H, Mantel–Haenzel.
Figure 4
Figure 4
Funnel plot for publication bias with ORR. Abbreviations: OR, odds ratio; ORR, objective response rate; SE, standard error.
See this image and copyright information in PMC

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