A retrospective six-patient series of apatinib for the treatment of persistent or recurrent carcinoma of the cervix

Figures & data

Table 1 Patients characteristics

Patient no	Age at diagnosis	Tumor stage at diagnosis	Differentiation	Surgery	Radiotherapy	Chemotherapy	Course of disease	OS (m)
1	36	IIb	Squamous G2	No	Yes	Yes	PR	21
2	56	IIa	Squamous G3	Yes	Yes	Yes	SD	7
3	46	IVb	Squamous G3	Yes	Yes	Yes	SD	12
4	53	IIb	Squamous G2	No	Yes	Yes	SD	16
5	51	IIa	Squamous G2	No	No	Yes	PD	10
6	53	IIIb	Squamous G3	Yes	Yes	Yes	PD	6

Table 2 Baseline of patients’ characteristics

Characteristic	N=6
Age (years)
Median	49.2
Range	36–56
ECOG
0–1	5
2	1
Prior therapy
Operation	3
Radiotherapy	5
Chemotherapy	6

Figure 3 Survival curve of PFS and OS after apatinib treatment. (A. PFS; B. OS).

Abbreviations: PFS, progression-free survival; OS, overall survival.

Figure 1 Waterfall plot for the best percentage change in target lesion size. Abbreviations: PD, progression disease; PR, partial response.

Figure 2 The CT scan of the cervical cancer patient.

Table 3 Adverse events on treatment (n=6 evaluable patients)

Adverse event	Grade 1/2	Grade 3/4
Non-hematologic
Hypertension	3(50%)	1(17%)
Mucositis	2(33%)
Fatigue	1(17%)
Anorexia	2(33%)
Albuminuria	1(17%)	1(17%)
Hand-foot syndrome	1(17%)
Gastrointestinal hemorrhage	1(17%)
Hematologic
Anemia		1(17%)
Leukopenia	1(17%)
Thrombocytopenia		1(17%)

Table 4 Clinic reports of anti-VEFGR in cervical cancer

Study	Agent	Mainly target	Trial design	N	Cohort	Response rate	Adverse Effects	Reference
Present	Apatinib	VEGFR-2	Retrospective	6	Advanced/recurrent	67% (4/6)	Manageable
2010	Pazopanib	VEGFR-1, 2, 3	Phase II	226	Persistent IVb, recurrent	PFS49.7 weeks	Manageable	[^Citation12]
2014	Sunitinib	VEGFR-1, 2, 3	Phase II	19	Local advance, resistant	–	Fistula 26%	[^Citation13]
2015	Cediranib	VEGFR-1, 2, 3	Phase II	69	Advanced/recurrent	Improved PFS, but not OS	–	[^Citation14]
2016	Brivanib	VEGFR, FGFR	Phase II	–	Advanced/recurrent	Suspended	Severe toxicity	[^Citation15]
2018	Apatinib	VEGFR-2	Phase II	–	Advanced/recurrent	Ongoing	Unknown	[^Citation16]

Shibuya M. Vascular endothelial growth factor (VEGF) and its receptor (VEGFR) signaling in angiogenesis: a crucial target for anti- and pro-angiogenic therapies. Genes Cancer. 2011;2(12):1097–1105. doi:10.1177/194760191142303122866201

 PubMedGoogle Scholar

Jo JC, Hong YS, Kim KP, et al. A prospective multicenter phase II study of sunitinib in patients with advanced aggressive fibromatosis. Invest New Drugs. 2014;32(2):369–376. doi:10.1007/s10637-013-0059-024425345

 PubMed Web of Science ®Google Scholar

Bender D, Sill MW, Lankes HA, et al. A phase II evaluation of cediranib in the treatment of recurrent or persistent endometrial cancer: an NRG Oncology/Gynecologic Oncology Group study. Gynecol Oncol. 2015;138(3):507–512.26186911

 PubMed Web of Science ®Google Scholar

Chan JK, Deng W, Higgins RV, et al. A phase II evaluation of brivanib in the treatment of persistent or recurrent carcinoma of the cervix: an NRG Oncology/Gynecologic Oncology Group study. Gynecol Oncol. 2017;146(3):554–559.28728751

 PubMed Web of Science ®Google Scholar

Zhou JG, Zhou NJ, Zhang Q, Feng YY, Zhou H. Apatinib for patients with advanced or recurrent cervical cancer: study protocol for an open-label randomized controlled trial. Trials. 2018;19(1):500.30223869

 PubMedGoogle Scholar