Apatinib in Patients with Relapsed or Refractory Diffuse Large B Cell Lymphoma: A Phase II, Open-Label, Single-Arm, Prospective Study.

Abstract

PURPOSE:

Treatment options for relapsed or refractory diffuse large B-cell lymphoma (RR DLBCL) represent an unmet medical need. Apatinib is a new oral tyrosine kinase inhibitor mainly targeting vascular endothelial growth factor receptor-2 (VEGFR-2) to inhibit tumour angiogenesis. In the present study, we evaluated the efficacy and safety of apatinib for patients with RR DLBCL.

PATIENTS AND METHODS:

In this phase II, open-label, single-arm, prospective study, we enrolled patients aged 14-70 years with treatment failure of at least two chemotherapeutic regimens using Simon's two-stage design. All patients were administered apatinib at an initial dose of 500 mg on a 4-week cycle at home and visited the outpatient clinic every two cycles to evaluate efficacy and to record adverse events. We considered objective response rate (ORR) as the primary end point, and progression-free survival (PFS), and overall survival (OS) plus duration of response (DoR) as the secondary end point. (This trial was registered at ClinicalTrials.gov, identifier: NCT03376958.).

RESULTS:

From January 2017 to February 2019, we screened 35 patients and enrolled 32 eligible patients. At the cutoff point (April 2019), we noted 2 (6.3%) complete responses, 12 (37.5%) partial responses, and 9 (28.1%) stable diseases, attributing to an ORR of 43.8% and a disease control rate of 71.9%. The median PFS and OS were 6.9 (95% confidence interval [CI], 5.8-7.9) and 7.9 months (95% CI, 7.0-8.7), respectively. The median DoR was 5.0 months (95% CI, 3.5-6.5) for patients who achieved PR. The most common grade 3-4 adverse events (AE) were hypertension (12.6%), hand-foot syndrome (9.4%), and leucopenia (6.3%). No apatinib-related deaths were noted.

CONCLUSION:

Home administration of apatinib shows promising efficacy and manageable AEs in patients with RR DLBCL.

• Authors: Xinran Ma, Ling Li, Lei Zhang, Xiaorui Fu, Xin Li, Xinhua Wang, Jingjing Wu, Zhenchang Sun, Xudong Zhang, Xiaoyan Feng, Yu Chang, Zhiyuan Zhou, Feifei Nan, Jieming Zhang, Zhaoming Li, Mingzhi Zhang
• Journal: Drug design, development and therapy (Drug Des Devel Ther) Vol. 14 Pg. 275-284 ( 2020) ISSN: 1177-8881 [Electronic] New Zealand
• PMID: 32158186 (Publication Type: Clinical Trial, Phase II, Journal Article, Randomized Controlled Trial)
• Copyright: © 2020 Ma et al.

Chemical References

• Antineoplastic Agents
• Protein Kinase Inhibitors
• Pyridines
• apatinib
• KDR protein, human
• Vascular Endothelial Growth Factor Receptor-2

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (administration & dosage, adverse effects, pharmacology)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Humans
• Lymphoma, Large B-Cell, Diffuse (drug therapy, metabolism, pathology)
• Male
• Middle Aged
• Prospective Studies
• Protein Kinase Inhibitors (administration & dosage, adverse effects, pharmacology)
• Pyridines (administration & dosage, adverse effects, pharmacology)
• Vascular Endothelial Growth Factor Receptor-2 (antagonists & inhibitors, metabolism)
• Young Adult