Apatinib significantly improved overall survival according to the results of a phase III study presented at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.

Gastric cancer refers to cancer of the stomach. Though gastric cancer has a relatively low incidence in the United States, it is the second leading cause of cancer death worldwide. The incidence of gastric cancer is quite high in Asian countries such as Korea, China, Taiwan, and Japan. Treatment of gastric cancer typically involves surgical removal of the cancer followed by the use of chemotherapy with or without radiation therapy.

The vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase inhibitor apatinib significantly prolonged overall survival in patients with advanced gastric cancer compared with placebo,

This phase III trial included patients with advanced gastric cancer who had failed prior second-line chemotherapy. The patients were randomly assigned to receive treatment with either apatinib or placebo.

Results of the study revealed an almost 2-month overall survival advantage for patients assigned to treatment with apatinib. The median overall survival was 6.5 months for apatinib compared with 4.7 months for placebo.  Progression-free survival was also improved with apatinib.

Treatment with apatinib was generally well tolerated and the main side effects consisted of low white blood cell counts, low platelet counts and toxicity to the skin know as hand-foot syndrome.

Studies will continue to evaluate apatinib to determine the optimal dosing and best way to use this novel drug alone or in combination with other chemotherapy in order to improve the outcomes of individuals with gastric cancer.

Reference: Qin S. Phase III study of apatinib in advanced gastric cancer: A randomized, double-blind, placebo-controlled trial. J Clin Oncol 32:5s, 2014 (suppl; abstr 4003)

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