Discussion
death, fatigue, cancer, thrombocytopenia, proteinuria, vomiting, TNBC, HER2-negative metastatic breast cancer, Nausea, HR-negative disease, hypertension
CANCER, THROMBOCYTOPENIA, TUMOR ANGIOGENESIS, TUMOR GROWTH, HYPERTENSION
TNBC is associated with poor prognosis, especially for heavily pretreated patients [Chemotherapy still plays a critical role in the treatment of TNBC. However, numerous clinical studies and practices show that chemotherapy has limited benefits, with the median OS ranged from 12.5 months to 13.4 months and the median PFS ranged from 2.8 months to 5.3 months for pretreated TNBC [Apatinib selectively binds to and inhibits VEGFR-2 activity, preventing tumor angiogenesis and inhibiting tumor growth [Antiangiogenic agents combined with chemotherapy may have a synergistic effect, thus improving the prognosis of cancer patients [Various other TKIs, either alone or in combination with chemotherapy, have been investigated for treating metastatic TNBC. A randomized clinical trial has compared sorafenib plus capecitabine with capecitabine alone in patients with HER2-negative metastatic breast cancer, and the median PFS was 4.3 months for sorafenib plus capecitabine and 3.0 months for capecitabine in patients with HR-negative disease [Overall, the treatment combination appeared to be well-tolerated in most patients. A total of 65% patients developed hypertension, and most of them were well controlled after anti-hypertension treatment. Nausea and vomiting occurred in 47.5% of patients. Four patients developed grade 3 AEs, including two with hypertension and two with proteinuria. No treatment-related death was reported. Similarly, the most common grade 3 or 4 treatment-related AEs of apatinib plus etoposide were hypertension, fatigue, and thrombocytopenia in previous studies [This study has some limitations. This is a single-arm trial with only 40 patients, so the results may be biased due to the small sample size and lack of a control. Therefore, further phase III randomized controlled trial with increased sample size should be conducted to further investigate the role of apatinib plus etoposide for patients with TNBC.In conclusion, apatinib in combination with oral etoposide was feasible in pretreated advanced TNBC, with the advantage of ease of administration.