文献类型：期刊文献

英文题名：First-line application of apatinib combined with S-1 based on peripheral circulating tumor cell screening to treat advanced gastric adenocarcinoma: a case report

作者：Chen, Weikai[1,2];Yu, Jianping[2];Zhang, Yanan[1,2];Wang, Wenjie[3];Yu, Wenwen[2];Shi, Xin[2];Xu, Zipeng[3];Liu, Hongbin[1,2,3]

第一作者：Chen, Weikai

通信作者：Liu, HB[1]

机构：[1]Gansu Univ Chinese Med, Clin Med Coll, Lanzhou 730000, Gansu, Peoples R China;[2]940 Hosp Chinese Peoples Liberat Army Joint Logis, Dept Gen Surg, 333 Binhe South Rd, Lanzhou 730050, Gansu, Peoples R China;[3]Lanzhou Univ, Clin Med Coll 2, Lanzhou 730030, Gansu, Peoples R China

第一机构：甘肃中医药大学临床医学院

通信机构：[1]corresponding author), 940 Hosp Chinese Peoples Liberat Army Joint Logis, Dept Gen Surg, 333 Binhe South Rd, Lanzhou 730050, Gansu, Peoples R China.

年份：2019

卷号：7

期号：8

外文期刊名：ANNALS OF TRANSLATIONAL MEDICINE

收录：;WOS:【SCI-EXPANDED(收录号:WOS:000466524800021)】；

基金：This study was supported by the Huimin Plan of Ministry of Science and Technology & Ministry of Finance, China (grant No. 2012GS620101). the Major Projects of Science and Technology in Gansu Province of China (grant No. 2011GS04390), the Natural Science Foundation of in Gansu Province of China (grant No. 1506RJZA309), and the Postdoctoral Research Foundation of China (grant No. 2015M572710).

语种：英文

外文关键词：Apatinib; advanced gastric cancer (AGC); liver metastasis; peripheral circulating tumor cells (pCTC); targeted therapy

摘要：Apatinib mesylate, a small-molecule tyrosine kinase inhibitor (TKI) of vascular endothelial growth factor receptor-2 (VEGFR-2), has been recommended as a third-line class A agent for patients with advanced gastric adenocarcinoma in China since April 2018. Thus far, there is no case report on the combined use of apatinib and S-1 as the first-line treatment option for metastatic gastric cancer (GC) patients based on peripheral circulating tumor cell (pCTC) monitoring. We present a unique case in which liver metastases originating from GC gradually shrank and disappeared in the presence of pCTC-positive disease after treatment with apatinib for 17 months. More surprisingly, the pCTCs became negative after the addition of S-1 halfway through treatment. A 71-year-old Chinese man who underwent gastroscopic biopsy and laparoscopy was diagnosed with gastric adenocarcinoma with multiple liver metastases. The pathological stage was T4NxM1. The patient obtained clinical benefit from first-line apatinib within 4 weeks. After developing grade 2 hand-foot syndrome, the patient began to take S-1 alone. When the condition was significantly relieved, the elderly patient continued to take apatinib combined with S-1 and achieved satisfactory therapeutic results. Many studies suggest that the prognosis of this type of GC is grim. However, apatinib increased the overall survival (OS) duration of the patient to 34 months. We hypothesize that combining apatinib with S-1 as a first-line therapeutic option for pCTC-positive advanced GC is feasible.