High-grade gliomas (HGGs) are the most common and aggressive group of primary central nervous system (CNS) tumors. They are characterized by diffuse parenchymal infiltration and prominent angiogenesis. Apatinib is a novel inhibitor of VEGFR-2, which was admitted for the treatment of advanced gastric cancer patients who had failed after the second-line and above treatment. However, there have been no reports for treating recurrent high-grade gliomas with this drug.
This was a single-arm, open-label, exploratory study design. Eligibility criteria included histologically proven glioma, patient age 18-75 years. A history of receiving previous treatment was not required. All the patients were orally given apatinib at an initial dose of 500-850 mg (qd) and irinotecan (125 mg/m2) on days 1, 8 of each 21-day cycle. After 6 cycles, patients were treated with apatinib 500-850 mg (qd) until disease progression or death.
A total of 10 patients including 7 males and 3 females were eligible. The median age was 49 years (range 27-66 years). Among the 10 patients, 9 were available for the efficacy evaluation. Two patients achieved partial response (PR), 3 had stable disease (SD), and 4 had progressive disease (PD). The objective response rate (ORR) and the disease control rate (DCR) were 22.22% (2/9) and 55.56% (5/9), respectively. All patients were included for safety analysis. The incidence of adverse events (AEs) was 100%. The common AEs were bone marrow suppression (50%) and hypertension (40%), gastrointestinal reaction (30%), diarrhoea (30%) and sinus rhythm (20%).
Apatinib combined with irinotecan is an active regimen for patients with recurrent high-grade gliomas with a comparable disease control and tolerable adverse reactions.
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All authors have declared no conflicts of interest.