Safety and Efficacy of of apatinib combined with chemotherapy in the second-line and subsequent lines of advanced gastric cancer: A systematic review and meta-analysis

Abstract

Abstract Objective A meta-analysis was performed to compare the efficacy and safety of apatinib combined with chemotherapy in the second-line and subsequent lines of advanced gastric cancer. Methods A computerized systematic search of databases such as PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and VIP e-Journals was performed to find literature comparing apatinib combined with chemotherapy in the treatment of advanced gastric cancer.Literature search, quality assessment and data extraction were performed independently by two researchers. Stata 16 software was used to process and analyze the data. And, we assessed heterogeneity with I2 and p-value, and performed sensitivity analysis. Results A total of 1217 patients with advanced gastric cancer were included in 13 studies, including 652 patients in the apatinib combined with chemotherapy group and 565 in the chemotherapy group.Meta-analysis results showed that the objective response rate (ORR) of the observation group was better than that of the control group(0R = 2.49, 95% CI = 1.86–3.34), and the disease control rate (DCR) of the observation group was also better than that of the control group(OR = 2.78,95% CI = 2.11–3.66).The R0 resection rate was also statistically significant(OR = 2.31, 95% CI = 1.09–4.92).In addition, when comparing total adverse reactions (AEs) at any level, there was a statistical difference(OR = 1.61, 95%CI = 1.39–1.86). Conclusion Compared with the chemotherapy group, apatinib combined with chemotherapy has better efficacy and controllable safety in advanced gastric cancer.