Efficacy And Safety Of Apatinib Combined With Chemotherapy In Patients Of Cervical Cancer With Pulmonary Metastasis

The prognosis of recurrent and metastatic cervical cancer is poor, especially when complicated with pulmonary metastasis. The objective of this study was to explore the efficacy and safety of apatinib combined with chemotherapy in the treatment of cervical cancer with pulmonary metastasis. This is a prospective, exploratory, single-arm and single-center trial. Eligible patients were over 18 years old, Eastern Cooperative Oncology Group (ECOG) performance score of 0-2, life expectancy higher than 3 months. All the patients were treated with apatinib combined with chemotherapy. The primary endpoint was investigator-assessed objective response rate (ORR). Secondary endpoint was progression-free survival (PFS), overall survival (OS), safety, tolerability and disease control rate (DCR). From January 2018 to July 2020, 24 squamous cell cervical carcinoma with pulmonary metastasis patients were enrolled in the study. No complete remission (CR), 18 partial remission (PR), 3 stable (SD), 3 partial progression (PD), the ORR was 75%, and the DCR was 87.5%. The median PFS was 5.0 months (95%CI: 3.055-6.945 months), and the median OS was 13.0 months (95%CI: 11.95-14.05 months). The 1-year survival rate was 62.5% and the 2-year survival rate was 16.6%. The median PFS was 5.5 months and median OS was 17.5 months in patients with simple pulmonary metastasis. The main adverse reactions of apatinib combined chemotherapy were as follows, proteinuria 16.67%, nausea and vomiting 62.5%, hand and foot syndrome 8.33%, hypertension 29.17%, neutropenia 58.33%, thrombocytopenia 25%, hematuria 4.16%. Most of the adverse reactions were grade 1-2. There were 5 cases of radge 3 treatment-related adverse events, including hypertension 1 case, proteinuria 1 case, urinary occult blood 1 case and neutrophils 2 cases. There was no grade 4 adverse events. Apatinib combined with chemotherapy produced good disease control rate and safety for cervical cancer patients with pulmonary metastasis.