Efficacy and safety assessment of apatinib in patients with advanced gastric cancer: a meta-analysis

Aim: This meta-analysis was performed to evaluate the efficacy and safety of apatinib in patients with advanced gastric cancer (AGC). Methods: After evaluating the inclusion and exclusion criteria, the data of eligible randomized clinical trials (RCTs) were extracted. Outcomes including objective response rate (ORR), disease control rate (DCR), and adverse events (AEs) were analyzed in the meta-analysis. Results: Data of 1,069 patients from 13 RCTs were statistically analyzed. Pooled odds ratio (OR) for ORR and DCR was found to be 0.46 (95% confidence interval [CI]: 0.33, 0.64; P<0.00001) and 0.23 (95% CI: 0.15, 0.36; P<0.00001), respectively. Compared with placebo, apatinib showed statistical significance in AEs at any grade, including leucopenia, neutropenia, thrombocytopenia, diarrhea, hypertension, proteinuria, hand-foot syndrome, and fatigue (all P<0.05). Conclusion: The results of our meta-analysis revealed that apatinib shows short-term efficacy over no-apatinib regimens or placebo regardless of its use as first- or second-line chemotherapy or for further treatment in patients with AGC accompanied with apparent Alis of any grade.