ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1578011
The evaluation of the efficacy and safety about Apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study
Provisionally accepted
- Zhejiang Provincial People's Hospital, Hangzhou, China
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Apatinib and immune checkpoint inhibitors (ICIs) have shown promise as third-line treatments for advanced gastric cancer (AGC). This study compared the efficacy and safety of apatinib combined with ICIs versus apatinib monotherapy in AGC patients after second-line treatment failure.We conducted a retrospective analysis of 48 AGC patients with postoperative recurrence/metastasis treated at Zhejiang Provincial People's Hospital between January 2018 and September 2022. Patients received either apatinib plus ICIs (n=23) or apatinib alone (n=25). Primary endpoints were overall survival (OS) and progression-free survival (PFS); Secondary endpoints included safety and subgroup analyses.With median follow-up of 4.25 months, the combination group showed significantly longer median OS (6.0 vs 3.0 months, HR=0.44, 95%CI 0.24-0.82, P=0.009) and PFS (3.0 vs 2.0 months, P=0.155).Subgroup analysis revealed patients with liver metastasis receiving combination therapy had superior 2 OS (7.5 vs 4.0 months, P=0.036). The objective response rate was higher with combination therapy (4.3% vs 0%), though not statistically significant (P=0.292). Safety profiles were comparable between groups, with no significant increase in severe adverse events with combination therapy.Apatinib combined with ICIs demonstrated improved survival outcomes compared to apatinib monotherapy in AGC, particularly for patients with liver metastasis, without increasing severe toxicity.
Keywords: gastric cancer, Immunotherapy, Apatinib, survival time, prognosis, antiangiogenesis
Received: 17 Feb 2025; Accepted: 23 May 2025.
Copyright: © 2025 Zhu, Yang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Liu Yang, Zhejiang Provincial People's Hospital, Hangzhou, China
Zheling Chen, Zhejiang Provincial People's Hospital, Hangzhou, China
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