As a novel
vascular endothelial growth factor receptor-2 tyrosine kinase inhibitor (VEGFR2-TKI),
apatinib has a certain anti-
tumor effect for a variety of solid
tumors. The present study evaluates its efficacy and safety in advanced
hepatocellular carcinoma (HCC). In this study, 47 patients with advanced HCC were included. TACE monotherapy group included 22 patients that responded to TACE, while the group that received TACE and
apatinib included 25 patients that progressed on TACE and were able to receive
apatinib off label. Median overall survival (OS) was significantly improved in the
apatinib plus TACE group compared with the TACE group. Similarly,
apatinib in combination with TACE significantly prolonged median progression-free survival (PFS) compared with TACE monotherapy. Furthermore, there was a significant difference between combination
therapy and monotherapy in both Barcelona clinic
liver cancer (BCLC) B and BCLC C group. The combination
therapy had a dramatic effect on OS and PFS for patients at both BCLC B and BCLC C level. The most common clinically adverse events of
apatinib plus TACE group were
fatigue,
weight loss,
hypertension,
hand-foot syndrome and
anorexia, which were manageable and tolerable. The efficacy analysis showed that there was no significant association of survival benefit with age, gender, Eastern Cooperative Oncology Group (ECOG) performance status,
hypertension and
hand-foot syndrome. Patients with macrovascular invasion and extrahepatic invasion showed worse survival benefits. In conclusion,
apatinib combined with TACE revealed certain survival benefits for HCC patients who experienced progression following TACE, which can provide a promising strategy for HCC treatment.