Clinical Observation Of Apatinib Plus S-1As Posterior Line Treatment In Patients With Metastatic Nasopharyngeal Carcinoma

Objective: To observe the efficacy and safety of apatinib combined with S-1 in the posterior line treatment of metastatic nasopharyngeal carcinoma,and to provide a new treatment option for advanced metastatic nasopharyngeal carcinoma with failed first-line treatment.Methods: A clinical study of oncology department,Xiangxi Autonomous Prefecture People’s Hospital,bring into 18 cases that were used at least first-line treatment of a platinum-based chemotherapy in metastatic nasopharyngeal carcinoma patients ranged from August 1,2017 to August 1,2019.The posterior line was treated with apatinib +S-1.Specific solutions for: Apatinib mesylate: 375 mg per day(taking 500 mg Qod alternant with 250 mg Qod by oral way),sustained medication;S-1: 40 mg twice per day for 1-14 days and one cycle every 21 days.Evaluate efficacy and record adverse reactions.Results: 1.Eighteen patients with metastatic nasopharyngealcarcinoma were enrolled,0 patient of complete response(CR),7 patients of partial response(PR),9 patients of stable disease(SD)and 2 patients of progressive disease(PD).The objective response rate(ORR)was38.9%,and the disease control rate(DCR)was 88.9%.2.The median follow-up time was 17.3 months(range from 6.0 to23.2 months),median progression-free survival was 7.2 months(95%CI:5.1 to 9.4 months).The overall survival was 10.6 months(95%CI: 8.7 to12.5 months).3.Stratified analysis of hepatic metastasis showed that patients with hepatic metastasis had poor efficacy,PFS and OS were significantly shorter than those without hepatic metastasis.Progression-free survival of patients with and without hepatic metastasis was 5.6 months versus 9.7months,and progression-free survival of patients without hepatic metastasis was longer than that of patients with hepatic metastasis,but the difference was not statistically significant(P=0.064).The overall survival of patients with and without hepatic metastasis was 8.6 months versus13.5 months.The overall survival of patients without hepatic metastasis was longer than that of patients with hepatic metastasis,and the difference was statistically significant(P=0.009).4.The adverse reactions of most patients were rangd from grade I to grade II.The most frequently observed adverse events were anorexia(100.0%),pharyngalgia(83.3%),anemia(72.2%),leukopenia(66.7%),fatigue(55.6%).The grade III adverse reactions include leukopenia,anemia,thrombocytopenia,hypertension,hemorrhage,pharynga lgia.There was 1 case with grade 4 anemia and no treatment-related death.Conclusion: Apatinib combined with S-1 is effective and safe in the treatment of metastatic nasopharyngeal carcinoma,which could be one of the options for posterior line treatment of metastatic nasopharyngeal carcinoma.