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  

Clinical study of apatinib combined with paclitaxel chemotherapy in the treatment of paclitaxel-resistant advanced gastric cancer

作　　者：赵珅[1] 范南峰[1] 李惠[1] 刘捷[1] 俞嘉青 林榕波[1] ZHAO Shen;FAN Nanfeng;LI Hui;LIU Jie;YU Jiaqing;LIN Rongbo(Department of Abdominal Oncology,Fujian Provincial Cancer Hospital,Fuzhou,Fujian 350014,China)

机构地区：[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

出　　处：《福建医药杂志》2020年第1期16-19,共4页Fujian Medical Journal

基　　金：福建省医学创新课题(2016-CX-12)。

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850mg阿帕替尼靶向治疗同时联合单药紫杉醇化疗,3例给予850mg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。Objective The present study aimed to investigate the efficacy and safety of apatinib combined with paclitaxelcontained 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 850mg 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 4.4months[95CI%:(2.1,6.7)months],and median overall survival(OS)of 6.9months[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.

关 键 词：胃癌 阿帕替尼 耐药性逆转 含紫杉醇化疗 

分 类 号：R735.2[医药卫生—肿瘤]