Background
cancers, gastric or gastroesophageal adenocarcinoma, gastroesophageal junction cancer, deaths, gastric cancer
GASTRIC CANCER, CANCERS, GASTROESOPHAGEAL JUNCTION CANCER, TUMOR PROGRESSION, ONCOLOGY, GASTRIC CANCER
Gastric cancer, one of the most common cancers worldwide, ranks fifth in incidence with an estimated 1,089,000 new cases and fourth in mortality with 769,000 deaths in 2020 [Targeting angiogenesis has been validated as an effective way to combat tumor progression. Apatinib is a small-molecule tyrosine kinase inhibitor that highly selectively binds to and potently blocks vascular endothelial growth factor receptor 2 (VEGFR-2) [Apatinib was approved by the National Medical Products Administration as a third- or later-line treatment for advanced or metastatic gastric or gastroesophageal adenocarcinoma in China in October 2016. Currently, apatinib is the only tyrosine kinase inhibitor approved in China for gastric cancer patients who have received at least two lines of chemotherapy and is recommended by the Chinese Society of Clinical Oncology. Furthermore, the ATTRACTION-02 study showed that nivolumab improved OS in Asian patients with advanced gastric or gastroesophageal junction cancer compared with placebo as a third- or later-line treatment [Apatinib is the first treatment option approved in China for patients with heavily pretreated advanced gastric cancer. However, data from the phase II and phase III trials may not fully represent the safety and efficacy profiles of the drug in real-world clinical settings. Phase IV studies, with the advantage of a broad population and proximity to clinical practice, could provide more comprehensive information on licensed agents. Here we report a large-scale, prospective, multicenter study (AHEAD) to verify the safety and efficacy of apatinib in patients with advanced or metastatic gastric or gastroesophageal adenocarcinoma after at least two lines of chemotherapy.