| BackgroundAngiogenesis is a key part of tumor growth and spread and requires a concerted action by a large number of cytokines and cell surface receptors.Two high-affinity receptors for vascular endothelial growth factor(VEGF)-A:VEGFR-1 and VEGFR-2 act synergistically on physiological angiogenesis in embryogenesis.VEGFR-2 is a direct and major signal transducer for pathological angiogenesis through its strong tyrosine kinase activity in collaboration with many other signal transductions.Apatinib is a small molecule tyrosine kinase inhibitor that targets VEGFR(vascular endothelial growth factor receptor)-2.The MTD(maximum tolerated dose)is 850 mg once a day.Drug-related adverse events(AE)include hypertension 69.5%,proteinuria 47.8%,hand-foot skin reaction 45.6%,fatigue and diarrhea.In 2014,it was approved for third-line and third-line treatment of advanced gastric cancer or gastroesophageal junction adenocarcinoma.In other cancers such as non-small cell lung cancer(NSCLC),breast cancer,ovarian cancer and sarcoma,hepatocytes Cancer and the like also show certain anticancer activities.MethodsA retrospective study was conducted to collect the pathological diagnosis of advanced malignant tumors with multi-line treatment failure and the survival of patients with tumors in the Sino-Japanese Friendship Hospital during the period from August to February 2018.They were treated with abatinib 500mg/day and 28 days for one cycle.At the same time,they were treated with Jianpi Zishen Recipe and treated with traditional Chinese medicine for the treatment of adverse reactions related to apatinib.The clinical data of the patients were counted,and the efficacy of apatinib(CR,PR,SD,PD,ORR,DCR,etc.)was evaluated according to the RECIST 1.1 criteria,and the patients' progress free survival(PFS)and overall survival were observed,(overall servival,OS),according to the NCI 4.0 standard,the adverse reactions of apatinib were analyzed and the treatment of traditional Chinese medicine was analyzed.ResultsIn this study,84 patients were enrolled.After 28 days of treatment with apatinib,the overall respongse rate(ORR)was 18%,and the disease control rate(DCR)was 63%.Among them,sarcoma,breast cancer,and NSCLC.The disease control rates of SCLC.ovarian cancer.gastric cancer,and colorectal cancer were 83%.71.5%,68%,63.6%,60%,58.3%.and 57%,respectively.The median progression free survival(mPFS)was 4.8(3.0-6.6 95%confidence interval)months,and the mPFS of NSCLC.SCLC.sarcoma,breast cancer,ovarian cancer.gastric cancer,and colorectal cancer were 4.8.respectively,3.8.7.4.3.4.6.4.9.3.93 months.The median overall servival(mOS)was 6.9(6.0 to 7.8 95%confidence interval)months.The mOS of NSCLC,SCLC,sarcoma,breast cancer,ovarian cancer,gastric cancer,and colorectal cancer were 6.3,4.8.15.7,10.3,10.9,6.5,and 7.6 months,respectively.Univariate analysis using the Kaplan-Meier method found that the effect of age,sender,and ECOG score on survival in this study was not statistically significant in this study.The incidence of hypertension during the medication was 38%.the incidence of proteinuria was 29.7%,the incidence of HFSR was 20.2%.,the incidence of diarrhea was 11.9%.the incidence of fatigue was 16.6%,and the incidence of adverse hematologic reactions was 19%.Mainly for grade 1?2 adverse reactions.ConclusionsIn this study,84 patients showed higher objective response rate and disease control rate,and prolonged PFS and OS.especially in gastric cancer,sarcoma,and SCLC,indicating the efficacy of apatinib combined with traditional Chinese medicine in the treatment of advanced malignant tumors..In terms of adverse reactions,the patients in this study cooperated with traditional Chinese medicine treatment,and the incidence and severity of adverse reactions were lower than those reported in the literature,indicating that the adverse reactions of traditional Chinese medicine prevention and treatment are worthy of promotion.Further randomized controlled large-scale studies should be conducted. |
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