An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinoma

Abstract Purpose To evaluate the clinical efficacy and safety of apatinib combined with intensity‐modulated radiation therapy (IMRT) in patients with unresectable hepatocellular carcinoma (uHCC). Materials and methods Open‐label, single‐arm, exploratory clinical trial of apatinib combined with IMRT...

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Main Authors: Hu Qiu, Shaobo Ke, Gaoke Cai, Yong Wu, Jin Wang, Wei Shi, Jiamei Chen, Jin Peng, Baoping Yu, Yongshun Chen
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.4900
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author Hu Qiu
Shaobo Ke
Gaoke Cai
Yong Wu
Jin Wang
Wei Shi
Jiamei Chen
Jin Peng
Baoping Yu
Yongshun Chen
author_facet Hu Qiu
Shaobo Ke
Gaoke Cai
Yong Wu
Jin Wang
Wei Shi
Jiamei Chen
Jin Peng
Baoping Yu
Yongshun Chen
author_sort Hu Qiu
collection DOAJ
description Abstract Purpose To evaluate the clinical efficacy and safety of apatinib combined with intensity‐modulated radiation therapy (IMRT) in patients with unresectable hepatocellular carcinoma (uHCC). Materials and methods Open‐label, single‐arm, exploratory clinical trial of apatinib combined with IMRT for uHCC patients. Patients aged 18–75 years with adequate hematological, liver, and renal functions and Eastern Cooperative Oncology Group (ECOG) performance status of ≤2 were enrolled in this study from March 2017 to September 2020. Patients were received IMRT (biological effective dose: 46–60 Gy) and continuous apatinib (250–500 mg/day) oral administration until HCC progression or unacceptable toxic effects. The endpoints included progression‐free survival (PFS), overall survival (OS), disease control rate (DCR), objective response rate (ORR), and safety. The trial registration number is ChiCTR‐OPC‐17011890. Results A total of 33 patients have taken part in the study. The median age was 58 years old (range 32–77), 27 (81.9%) patients were ECOG PS 0–1, and 28 (84.9%) patients were male. In addition, 25 (75.7%) patients suffered from hepatitis B, 32 cases (97.0%) were in Barcelona Clinic Liver Cancer (BCLC) Stages B–C, and eight (24.2%) had portal vein involvement. Moreover, 12 (36.4%) and 21 (63.6%) patients received apatinib as first‐line and second or later‐line therapy, respectively. The average follow‐up was 11.4 months, the median PFS was 7.8 months (95% confidence interval: 3.9–11.7). The OS rates at 6 and 12 months were 96.7% and 66.2%. The ORR and DCR were 15.1% and 81.8%, respectively. Hepatic toxicity was the most common treatment‐related adverse events in Grades 3–4 (12.1%). No radiation‐induced liver disease and Grade 5 toxicity were recorded. Conclusion Apatinib combined with IMRT is a safe and effective method to improve PFS and DCR and has good anti‐tumor activity in patients with uHCC.
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spelling doaj.art-e160f46dd6cc4a8cbd6159ee33073ba42023-01-17T17:10:24ZengWileyCancer Medicine2045-76342023-01-0112121322210.1002/cam4.4900An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinomaHu Qiu0Shaobo Ke1Gaoke Cai2Yong Wu3Jin Wang4Wei Shi5Jiamei Chen6Jin Peng7Baoping Yu8Yongshun Chen9Department of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Radiation and Medical Oncology Zhongnan Hospital of Wuhan University Wuhan ChinaDepartment of Gastroenterology Renmin Hospital of Wuhan University Wuhan ChinaDepartment of Clinical Oncology Renmin Hospital of Wuhan University Wuhan ChinaAbstract Purpose To evaluate the clinical efficacy and safety of apatinib combined with intensity‐modulated radiation therapy (IMRT) in patients with unresectable hepatocellular carcinoma (uHCC). Materials and methods Open‐label, single‐arm, exploratory clinical trial of apatinib combined with IMRT for uHCC patients. Patients aged 18–75 years with adequate hematological, liver, and renal functions and Eastern Cooperative Oncology Group (ECOG) performance status of ≤2 were enrolled in this study from March 2017 to September 2020. Patients were received IMRT (biological effective dose: 46–60 Gy) and continuous apatinib (250–500 mg/day) oral administration until HCC progression or unacceptable toxic effects. The endpoints included progression‐free survival (PFS), overall survival (OS), disease control rate (DCR), objective response rate (ORR), and safety. The trial registration number is ChiCTR‐OPC‐17011890. Results A total of 33 patients have taken part in the study. The median age was 58 years old (range 32–77), 27 (81.9%) patients were ECOG PS 0–1, and 28 (84.9%) patients were male. In addition, 25 (75.7%) patients suffered from hepatitis B, 32 cases (97.0%) were in Barcelona Clinic Liver Cancer (BCLC) Stages B–C, and eight (24.2%) had portal vein involvement. Moreover, 12 (36.4%) and 21 (63.6%) patients received apatinib as first‐line and second or later‐line therapy, respectively. The average follow‐up was 11.4 months, the median PFS was 7.8 months (95% confidence interval: 3.9–11.7). The OS rates at 6 and 12 months were 96.7% and 66.2%. The ORR and DCR were 15.1% and 81.8%, respectively. Hepatic toxicity was the most common treatment‐related adverse events in Grades 3–4 (12.1%). No radiation‐induced liver disease and Grade 5 toxicity were recorded. Conclusion Apatinib combined with IMRT is a safe and effective method to improve PFS and DCR and has good anti‐tumor activity in patients with uHCC.https://doi.org/10.1002/cam4.4900apatinibhepatocellular carcinomaradiation therapyvascular endothelial growth factor
spellingShingle Hu Qiu
Shaobo Ke
Gaoke Cai
Yong Wu
Jin Wang
Wei Shi
Jiamei Chen
Jin Peng
Baoping Yu
Yongshun Chen
An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinoma
Cancer Medicine
apatinib
hepatocellular carcinoma
radiation therapy
vascular endothelial growth factor
title An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinoma
title_full An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinoma
title_fullStr An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinoma
title_full_unstemmed An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinoma
title_short An exploratory clinical trial of apatinib combined with intensity‐modulated radiation therapy for patients with unresectable hepatocellular carcinoma
title_sort exploratory clinical trial of apatinib combined with intensity modulated radiation therapy for patients with unresectable hepatocellular carcinoma
topic apatinib
hepatocellular carcinoma
radiation therapy
vascular endothelial growth factor
url https://doi.org/10.1002/cam4.4900
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