Clinical Evaluation Of The Therapeutic Effect Of Apatinib On Advanced Hepatocellular Carcinoma

Purpose:The aim of this study was to evaluate the safety and efficacy of apatinib,a second-generation vascular endothelial growth factor receptor-2 inhibitor and a potent antiangiogenic agent,in patients with advanced hepatocellular carcinoma.Methods:Patients,receiving oral apatinib at doses of 500 mg/day or 250 mg/day for unresectable or recurrent metastatic hepatocellular carcinoma(BCLC-C)in Tianjin Medical University Cancer Institute and Hospital was studied retrospectively.22 patients were assessed for the time to disease progression,disease control rate,overall survival,and safety finally.Tumor response was measured according to the RECIST 1.1.The adverse effects were rating according to the NCI-CTCAE version 3.0.The prognostic significance of clinical factors on time to progression was investigated by univariate analysis using the log-rank test and Cox proportional hazards model was used in multivariate analysis.Results:According to the RECIST1.1 standard,all of the 22 patients can be evaluated for therapeutic effects.Complete response(CR)rate was 0%(0/22),partial response(PR)rate was 40.9%(9/22),stable disease(SD)rate 40.9%(9/22),and progressive disease(PD)rate 18.2%(4/22).The objective response rate(CR + PR)was 40.9%(9/22)and the disease control rate(CR + PR + SD)was 81.8 %(18/22).The median TTP of 22 patients under the treatment of apatinib was 10.4 months(95% CI,3.4 months-17.5 months).Until the last investigation,half of the patients had lived 8.0 months since first dose.In univariate analysis,ALB≥40.0g/L,TBIL<21.0μmol/L,PLT<125×109/L and post treatment AFP declination were the prognostic factors on TTP;In multivariate analysis,PLT<125×109/L and post treatment AFP declination were independent prognostic factors which affected TTP.The most common apatinib-related adverse events were hand-foot skin reaction(HFSR)(81.8%)and diarrhea(77.3%).The most common apatinib-related grade Ⅲ-Ⅳadverse events were hypertension(27.3%)and HFSR(13.6%).Conclusions:Treatment of apatinib resulted in an unprecedented therapeutic effect on patients with advanced HCC.It is imperative to design and carry out the relevant clinical trials to confirm its efficacy for the treatment of advanced HCC.