ABSTRACT
Objective:
To evaluate the
efficacy and
safety of the combination of apatinib and S-1 for
treatment of
patients with advanced
gastric cancer, in order to provide clinical
therapy reference for advanced
gastric cancer.
Methods:
Clinical trials were retrieved from
China National
Knowledge Infrastructure (CNKI) ,
Chinese Science and
Technology Journal Database (CSTJ) , Wanfang Medical Network, VIP Journal Database (VIP) ,
China Biomedical
Literature Database (CBMdisc) , Cochrane
Library,
PubMed, etc., searched from Jan. 2010 to Oct. 2019. The experimental group were given apatinib combined with S-1, and the
control group received S-1 monotherapy. Two sets of RCT in
patients with advanced
gastric cancer were collected.
Researchers first screened
literature, data extraction and to assess the
risk of
bias, then made Meta
analysis with RevMan5.3
software, the test level was α=0.05.
Results:
A total of 12 Meta
analysis of randomized RCT were selected from the group, including 561 cases of
patients. The results showed that objective response rate (ORR) and
disease control rate (DCR) of the experimental group was higher than those of the
control group [ (RD=0.16, 95% CI 0.08-0.23, P<0.0001; RD=0.21,95% CI 0.14-0.29, P<0.00001) ]; There was no significant difference in
nausea and
vomiting,
hand-foot syndrome,
fatigue,
diarrhea,
thrombocytopenia,
neutropenia,
leukopenia, neuro-
toxicity and
mucositis between the two groups. The rate of
hypertension,
proteinuria,
hemoglobin of the experimental group decrease was higher than that of the
control group [ (OR=6.21, 95% CI 1.92-20.13, P=0.002; OR = 10.57,95% CI 5.06-22.04, P<0.00001; OR=2.84, 95% CI1.25-6.48, P=0.01) ]; and there was a significant heterogeneity in
hypertension among them ( P=0.008, I 2=63) .
Conclusion:
Compared with S-1 alone, the
treatment effect of S-1 combined with targeted
drug apatinib can significantly improve ORR and DCR of
patients with advanced
gastric cancer.