Research Paper Volume 13, Issue 6 pp 8408—8420

Oral maintenance therapy using apatinib combined with S-1/capecitabine for esophageal squamous cell carcinoma with residual disease after definitive chemoradiotherapy

Dongmei Chi1,2,3, *, , Baoqing Chen1,2, *, , Suping Guo1,2, , Kunhao Bai4, , Huali Ma5, , Yonghong Hu1,2, , Qiaoqiao Li1,2, , Yujia Zhu1,2, ,

  • 1 Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, P.R. China
  • 2 Guangdong Esophageal Cancer Research Institute, Guangzhou, Guangdong, P. R. China
  • 3 Department of Anesthesiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
  • 4 Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, P.R. China
  • 5 Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, P.R. China
* Co-first author

Received: August 24, 2020       Accepted: January 21, 2021       Published: March 10, 2021      

https://doi.org/10.18632/aging.202652
How to Cite

Copyright: © 2021 Chi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: A substantial number of patients with esophageal squamous cell carcinoma (ESCC) do not achieve complete remission after definitive concurrent chemoradiotherapy (dCRT). We performed this retrospective study to evaluate the efficacy and safety of apatinib combined with S-1/capecitabine as the oral maintenance therapy for these patients.

Methods: Thirty-nine ESCC patients with residual disease after dCRT were included. Patients were treated with apatinib combined with S-1 /capecitabine after dCRT. Efficacy, toxicity, and survival were analyzed.

Results: Of the 39 patients, 5 (12.8%) achieved a partial response and 29 (74.4%) achieved stable disease, yielding a disease control rate of 87.2%. The median progression-free survival (PFS) and overall survival (OS) were 27.5 (95%CI: 14.9 - 40.1) and 38.1 (95%CI: 31.3 - 44.8) months. Most frequent adverse events were of grade 1 to 2. Multivariate analysis revealed the occurrence of any adverse events (HR = 0.274, 95%[CI] = 0.119 - 0.630) correlated to better PFS and occurrence of proteinuria (HR = 0.108, 95%[CI] = 0.025 - 0.456) predicted better OS.

Conclusion: The oral combination therapy consisting of apatinib and S-1/capecitabine showed a tolerable toxicity profile and achieved satisfactory disease control in ESCC patients with residual disease after dCRT.

Abbreviations

ESCC: esophageal squamous carcinoma; EC: esophageal carcinoma; dCRT: definitive concurrent chemoradiotherapy; PFS: progression-free survival; OS: overall survival; TKIs: tyrosine kinase inhibitors; TP: taxol and platinum; PF: platinum and fluorouracil; PR: partial remission; SD: stable disease; CR: complete remission; ORR: overall response rate; DCR: disease control rate.