Clinical efficacy and safety of apatinib as maintenance treatment in patients with advanced oesophageal squamous cell carcinoma.

BACKGROUND To investigate the clinical efficacy, safety and prognostic factors of apatinib therapy as maintenance treatment in patients with advanced oesophageal squamous cell carcinoma. RESEARCH DESIGN AND METHODS We selected 46 patients with advanced oesophageal squamous cell carcinoma treated with radiotherapy and chemotherapy in our hospital from January 2017 to February 2019, all of whom were treated with apatinib. We analysed the clinical efficacy, adverse reactions and prognostic factors. Meanwhile, the expression of VEGFR-2 and NF-kB was detected by the immunohistochemical SABC method, and the microvessel density and microlymphatic tube density were estimated. We analyzed the relationships between indicators, MVD and MLVD counts and the efficacy of apatinib. RESULTS The oral treatment of apatinib in the VEGFR-2 and NF-kB positive groups was better than that in the negative groups. The partial remission rate of patients was 26.09%, and the disease control rate was 67.39%. The main adverse reactions were hypertension (60.87%), hand-and-foot syndrome (34.77%), and proteinuria (36.96%). The degree of adverse reactions was mainly grade 1~2. The median progression-free survival was 3.7 months and the median overall survival was 7.2 months. Log-rank univariate analysis showed that the degree of adverse reactions and ECOG score were related to OS in patients with advanced oesophageal squamous cell carcinoma. Cox multivariate regression analysis showed that the degree of adverse reactions and ECOG score were independent factors affecting OS in patients with advanced oesophageal squamous cell carcinoma. CONCLUSION The positive expression of VEGFR-2 and NF-kB is expected to be the molecular target of oral apatinib targeted therapy for oesophageal cancer. Apatinib has a certain clinical effect as the maintenance treatment for advanced oesophageal squamous cell carcinoma patients, with mild adverse reactions and high safety.