Background and Purpose:
Apatinib is a novel
antiangiogenic agent that can target vascular endothelial cell
growth factor 2. The aim of our study was to evaluate the efficacy and safety of
apatinib mesylate in the treatment of advanced
hepatocellular carcinoma (HCC) in the real world. Methods: We retrospectively analyzed 178 patients with advanced HCC who had been treated with
apatinib mesylate from January 2017 to March 2020. The primary outcome indexes were progression-free survival (PFS) and overall survival (OS), and the secondary outcome indexes were overall response rate (ORR), disease control rate (DCR), and incidence of treatment-related adverse reactions. Results: Univariate analysis showed that patients with third-line treatment (p <0.001),
alpha fetoprotein (AFP) ≥400 ng/ml (p <0.05), distant
metastasis (p <0.05), portal vein
tumor thrombus (PVTT) (p <0.05), and
apatinib monotherapy (p <0.001) had shorter survival. Multivariate analysis confirmed that third-line drugs, PVTT, and combination
therapy were independent prognostic factors for PFS in all patients. Univariate analysis showed that Eastern Cooperative Oncology Group (ECOG) scores (p <0.05), line of
apatinib (p <0.001), AFP (p <0.001),
tumor progression (p <0.05), PVTT (p <0.05), and combination
therapy (p <0.001) may impact the OS. Multivariate analysis proved that AFP, PVTT, and combination
therapy were independent prognostic factors for OS. The most common adverse reactions were secondary
hypertension (29.21%), symptoms of
fatigue (16.85%), hand and foot syndrome (16.29%),
vomiting (14.04%),
liver dysfunction (6.18%), and
proteinuria (6.74%). Most of the adverse reactions were Grade 1 or 2. Conclusion:
Apatinib mesylate is an effective treatment for advanced HCC, and its adverse reactions are relatively mild. Line of
apatinib, PVTT, AFP level, and combination
therapy were independent prognostic factors for patients with advanced HCC who were treated with
apatinib.