Abstract: Background and purpose: Apatinib is the first oral cancer antiangiogenic drug in the world for advanced gastric cancer. With its wide application in clinics, finding suitable predictors of efficacy and screening for sensitive populations have become important issues. This study aimed to observe the efficacy and safety of apatinib in the treatment of advanced gastric cancer, and explore clinical prediction and prognostic factors. Methods: The clinicopathological features of 105 patients with advanced gastric cancer, who were treated with apatinib from Jan. 2015 to Aug. 2016, were analyzed retrospectively. All patients were given oral administration of apatinib. The indicators were treatment-related adverse reactions, disease control rate (DCR) and progression-free survival (PFS). We analyzed the relationship between clinicopathological features, treatment-related adverse reactions and prognosis. Results: The median PFS (mPFS) was 71 d (95%CI: 50.1-91.9 d), the objective response rate was 5.71%, and DCR was 65.71%. The univariate analysis showed that PFS was significantly prolonged among patients with one of the potential prognostic factors including age of >56 years, ECOG PS 0-1, dose 500 mg, hypertension, hand-foot skin reaction (HFSR) and proteinuria. The DCR was higher among patients with one of the potential prognostic factors including ECOG PS 0-1, dose 500 mg, hypertension, HFSR, proteinuria and diarrhea. Cox and logistic multivariate analysis showed that ECOG PS, dose, hypertension, HFSR were independent prognostic factors of PFS. ECOG PS 0-1, treatment-related HFSR, hypertension were significantly associated with DCR. Conclusion: Apatinib has good efficacy and safety in the patients with advanced gastric cancer. ECOG PS, HFSR, hypertension are the favorable prognostic factors of PFS and DCR, and the drug dose can be used as an independent predictor of PFS.

Key words: Gastric cancer, Apatinib, Multivariate analysis, Prognostic indicators