KEY TAKEAWAYS
- The study aimed to investigate the efficacy and safety of apatinib combined with S-1 in the 2L and above treatment of AGC.
- Researchers noticed that apatinib combined with S-1 is an effective option for the treatment of AGC; further investigation is ongoing.
Advanced gastric cancer (AGC) that does not respond to first-line (1L) therapy poses a challenge to clinical management. AGC is often diagnosed at an advanced stage, leading to poor prognosis and limited treatment options after the failure of initial therapies.
Xing Chen and the team aimed to compare the efficacy and safety of apatinib combined with S-1 in second-line (2L) and above treatment of AGC.
They performed an inclusive analysis by searching Cochrane Library, Science Direct, EMBASE, PubMed, and CNKI for randomized controlled trials until August 2023. Only patients who met the “Standardized Diagnosis and Treatment Guide for Gastric Cancer” were included in the study.
Accurate data were extracted, distinguishing between follow-up time and drug dose to reduce heterogeneity. The risk of bias in the included trials was evaluated according to the Cochrane Handbook. The survival benefit of the treatment was assessed based on clinical response rate, survival period, biochemical index, and adverse event (AE) occurrence.
About 29 randomized controlled trials involving 2149 participants were included in the meta-analysis. Statistically significant increases in clinical effective rate (OR = 2.61, 95% CI [2.13-3.20], P < .00001) and disease control rate (OR = 3.16, 95% CI [2.54-3.94], P < .00001) were found with apatinib combined with S-1.
This combination also had obvious advantages in reducing tumor markers and regulating immune factors. Additionally, apatinib combined with S-1 significantly increased the risk of hypertension but reduced damage to liver function, while the improvement of other AE’s was not pronounced.
The study concluded that apatinib combined with S-1 is more effective and safe for treating AGC in 2L and above. Despite efforts to minimize conclusion bias caused by basic data sources, further high-quality studies are necessary to validate these conclusions.
No funding information was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/38787998/
Chen X, Wan L, He Y, et al. (2024). “The efficacy and safety of apatinib combined with S-1 for advanced gastric cancer: A systematic review and meta-analysis.” Medicine (Baltimore). 2024 May 24;103(21):e38272. doi: 10.1097/MD.0000000000038272. PMID: 38787998; PMCID: PMC11124716.
