Meta-analysis of the efficacy and safety of Apatinib in the treatment of advanced gastric cancer

Objective: This study studied the efficacy and safety of Apatinib in the treatment of advanced gastric cancer. Methods: : Randomized controlled trials on the efficacy and safety of Apatinib in the treatment of advanced gastric cancer in recent years were searched in PubMed and PMC databases. Two members of the research team independently screened the literature, extracted the data and assessed the quality of the literature. Statistical software Rev Man 5.4 was used for meta-analysis of the included data. Results: : 12 literatures included in this study. The results showed that 540 patients in the experimental group and 465 patients in the control group. Apatinib can effectively increase CR (95%CI (1.49, 3.91), I 2 =0%, P=0.0004), PR (95%CI (1.49, 2.93), I 2 =0%, P<0.0001) and ORR (95%CI (2.27, 4.54), I 2 =0%, P<0.00001) and reduce PD (95%CI (0.22, 0.45), I 2 =0%, P<0.00001) in patients with advanced gastric cancer. It had no significant effect on SD (95%CI (0.72, 1.39), I 2 =0%, P=0.99). The results showed that Apatinib could effectively reduce the levels of CEA (95%CI (-9.35, -3.63), I 2 =98%, P<0.00001) and CA199 (95%CI (-11.20, -1.41), I 2 =100%, P=0.01) in patients with advanced gastric cancer. The results showed that there were no significant differences between Apatinib and the control group in nausea (95%CI (0.54, 1.37), I 2 =0%, P=0.52), myelosuppression (95%CI (0.54, 1.68), I 2 =0%, P=0.87), hypertension (95%CI (0.98, 3.01), I 2 =4%, P=0.06), and albuminuria (95%CI (0.63, 1.83), I 2 =5%, P=0.80) in the treatment of advanced gastric cancer. Apatinib in the treatment of advanced gastric cancer can significantly prolong mPFS (95%CI (0.43, 1.63), I 2 =93%, P=0.0008) and OS (95%CI (0.22, 2.43), I 2 =97%, P=0.02) in patients. Conclusion: Apatinib can stabilize the disease of patients, has obvious killing effect on cancer cells, acceptable side effects, can significantly prolong the life of patients, and has good clinical effect and prognosis in the treatment of advanced gastric cancer patients, which is worth promoting.