S-1 plus apatinib as first-line palliative treatment for stage IVB gastroesophageal junction adenocarcinoma: A case report and review of the literature.

Abstract

RATIONALE:

Apatinib has been proven to significantly prolong the survival of the patients with advanced chemotherapy-refractory gastric cancer. To date, studies on apatinib plus S-1 as first-line palliative therapy for metastatic gastroesophageal junction (GEJ) cancer are rare.

PATIENT CONCERNS:

A 61-year-old female patient was admitted with dysphagia, significant loss of body weight, and poor performance status.

DIAGNOSES:

Endoscopic biopsy revealed the diagnosis of poorly-differentiated GEJ adenocarcinoma, and the patient was clinically staged as T3NxM1G3 (IVB).

INTERVENTIONS:

She had received 4 cycles of palliative therapy using oral apatinib (425 mg daily) plus S-1 (40 mg twice daily for 4 weeks, with a 2-week drug-free interval), followed by maintenance low-dose apatinib (250 mg daily) plus S-1 at the same dosage thereafter.

OUTCOMES:

Her progression-free survival was nearly 5 months, and the overall survival was >11 months up to now. The adverse events were tolerable.

LESSONS:

Apatinib plus S-1 might be an alternative option for late-stage GEJ cancer. However, high-quality trials are warranted before the recommendation of this therapeutic regimen.

• Authors: Chu Zhang, Guang-Mao Yu, Miao Zhang, Dong Liu
• Journal: Medicine (Medicine (Baltimore)) Vol. 99 Issue 1 Pg. e18691 (Jan 2020) ISSN: 1536-5964 [Electronic] United States
• PMID: 31895837 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antineoplastic Agents
• Drug Combinations
• Pyridines
• S 1 (combination)
• Tegafur
• apatinib
• Oxonic Acid

Topics

• Adenocarcinoma (drug therapy)
• Antineoplastic Agents (administration & dosage)
• Drug Combinations
• Esophageal Neoplasms (drug therapy)
• Esophagogastric Junction
• Female
• Humans
• Middle Aged
• Oxonic Acid
• Pyridines (administration & dosage)
• Stomach Neoplasms (drug therapy)
• Tegafur