Abstract
ObjectivesThe NCCN guidelines recommend that the addition of bevacizumab should be considered in metastatic breast cancers in some circumstances, but there are no recommendations for the similar antiangiogenic drug apatinib. The aim of this study was to evaluate the safety and efficacy of apatinib in metastatic breast cancer patients pretreated with multiline treatment in a real-world setting.Materials and MethodsMetastatic breast cancer patients pretreated with multiline treatment who had apatinib treatment initiated from September 2015 to August 2019 at Shandong Cancer Hospital and Institute were included. The primary endpoints included PFS and OS, and the secondary endpoint was treatment-related toxicity.ResultsA total of 66 patients with metastatic breast cancer received apatinib treatment after failure of multiline chemotherapy in this study. The median PFS and OS of all 66 patients were 6.0 months and 10.0 months, respectively. The clinical beneficial rate was 40.9%. All patients tolerated treatment well, and no patients died of toxicity. The common toxicities of apatinib were hand and foot syndrome, secondary hypertension and fatigue events. The number of prior chemotherapy regimens was significantly associated with DFS and OS. Capecitabine may be a better choice for combination with a longer median OS of 19 months, while apatinib combined with other drugs was 9 months, and the apatinib monotherapy was 10 months.ConclusionApatinib produced moderate efficacy in metastatic breast cancer patients pretreated with multiline treatment with no significant treatment-related adverse events. Apatinib might be a choice for women as a maintenance salvage therapy following multiline chemotherapy failure.
Highlights
The incidence of breast cancer in the world was 1.9 million in 2017 in women, with an annual mortality of 601000 accounting for the number of deaths in females
A total of 66 metastatic breast cancer patients treated with apatinib were included
There was more than one organ metastasis (60.6%), including liver metastasis in 20 cases (30.3%), brain metastasis in 12 cases (18.2%), lung metastasis in 46 cases (69.7%), bone metastasis in 34 cases (51.5%), and lymph node metastasis in 39 cases (59.1%)
Summary
The incidence of breast cancer in the world was 1.9 million in 2017 in women, with an annual mortality of 601000 accounting for the number of deaths in females. Four percent of newly diagnosed breast cancer patients present with metastatic disease [1], which is associated with a poor prognosis and a median overall survival (OS) less than 3 years despite treatment [2]. As the first anti-VEGF agent, bevacizumab was recommended in the 2019 NCCN guidelines in certain circumstances because of the improved PFS in randomized clinical trials with the addition of bevacizumab to some first- or second-line treatments for metastatic breast cancer [5]. This evidence suggests that antiangiogenic drugs may be effective in a certain subtype of breast cancer patients
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