The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study

BackgroundApatinib 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.Methods...

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Main Authors: Peng-Fei Zhu, Liu Yang, Zhe-Ling Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1578011/full
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author Peng-Fei Zhu
Liu Yang
Zhe-Ling Chen
author_facet Peng-Fei Zhu
Liu Yang
Zhe-Ling Chen
author_sort Peng-Fei Zhu
collection DOAJ
description BackgroundApatinib 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.MethodsWe 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.ResultsWith 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 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.ConclusionApatinib combined with ICIs demonstrated improved survival outcomes compared to apatinib monotherapy in AGC, particularly for patients with liver metastasis, without increasing severe toxicity.
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spelling doaj-art-a40efd8f56634ffab4da9dc12fbdabc42025-08-20T02:32:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15780111578011The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world studyPeng-Fei ZhuLiu YangZhe-Ling ChenBackgroundApatinib 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.MethodsWe 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.ResultsWith 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 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.ConclusionApatinib combined with ICIs demonstrated improved survival outcomes compared to apatinib monotherapy in AGC, particularly for patients with liver metastasis, without increasing severe toxicity.https://www.frontiersin.org/articles/10.3389/fonc.2025.1578011/fullgastric cancerimmunotherapyapatinibsurvival timeprognosisantiangiogenesis
spellingShingle Peng-Fei Zhu
Liu Yang
Zhe-Ling Chen
The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study
Frontiers in Oncology
gastric cancer
immunotherapy
apatinib
survival time
prognosis
antiangiogenesis
title The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study
title_full The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study
title_fullStr The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study
title_full_unstemmed The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study
title_short The evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer: a real-world study
title_sort evaluation of the efficacy and safety about apatinib combined with immune checkpoint inhibitors in advanced gastric cancer a real world study
topic gastric cancer
immunotherapy
apatinib
survival time
prognosis
antiangiogenesis
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1578011/full
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