Low-Dosage Apatinib as Rescuing Treatment in Advanced Malignant Pleural Mesothelioma

Our plain-English summary of Low-Dosage Apatinib as Rescuing Treatment in Advanced Malignant Pleural Mesothelioma, by Y.Y. Liu, W.Y. Zhang, D.X. Zeng (American Journal of Therapeutics, 2020).

The study

• Authors: Y.Y. Liu, W.Y. Zhang, D.X. Zeng
• Journal: American Journal of Therapeutics
• Published: 2020;27(3):e326-e327
• Type of article: Case report, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor was a case report about one patient, a 69-year-old woman with malignant pleural mesothelioma, written by doctors at a hospital in Suzhou, China. It did not mention asbestos or any other cause of the disease. The patient first received pemetrexed with carboplatin, then pemetrexed alone, then gemcitabine with bevacizumab, then pemetrexed with bevacizumab, and the disease kept progressing. Because her condition was very poor (performance status score of 4), she was given a low dose of apatinib, an oral drug aimed at the VEGFR-2 receptor involved in blood-vessel growth in cancer, at 250 mg per day. Her breathlessness and cough improved after 3 weeks, and a CT scan at 6 weeks showed partial response. Side effects were high blood pressure and hand-foot syndrome, both grade 1. After 12 weeks the disease progressed, and she died of respiratory failure 4 weeks later. The authors concluded the report showed the potential value of apatinib in this disease. They said the best dose was undetermined and that more prospective studies were needed. A single case shows one person's outcome, not how often the drug works.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (letter to the editor) of a single patient
• Who was studied: One 69-year-old female patient with malignant pleural mesothelioma confirmed by pleural biopsy, who had cough and breathlessness for 1 year and a history of hypertension. The authors are from the Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Soochow University, Suzhou, China. Dates of treatment were not given.
• Exposure: No asbestos or other exposure was reported. The article studied a treatment: oral low-dosage apatinib (250 mg/d) given alone as salvage treatment after three earlier lines of therapy had failed.
• Main results:
  • Before apatinib, the patient received pemetrexed plus carboplatin for 4 cycles, then pemetrexed for 6 cycles, then gemcitabine plus bevacizumab for 4 cycles, then pemetrexed plus bevacizumab. After one cycle of the last treatment, the disease had progressed, with more pleural effusion and lung metastases, and her performance status score was 4.
  • Genetic testing (next-generation sequencing) of the patient's tumor showed FGFR1 amplification and TP53 mutation.
  • After 3 weeks of apatinib, the patient's dyspnea and cough were significantly improved. At 6 weeks, a CT scan showed partial response.
  • The patient's side effects were hypertension and hand-foot syndrome, both grade 1.
  • Twelve weeks later, the disease progressed. The patient died of respiratory failure 4 weeks after that. Progression-free survival on apatinib was 12 weeks.
• The authors' conclusion: The authors concluded that this report showed the potential value of apatinib in malignant pleural mesothelioma, and that more prospective studies are required to determine its clinical value.
• Limitations the authors state:
  • The authors stated that the most suitable dose of apatinib in malignant pleural mesothelioma was undetermined.
  • The authors stated that more prospective studies are required to determine the clinical value of apatinib in malignant pleural mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

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