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Journal of Cancer Prevention

Original Article

J Cancer Prev 2023; 28(3): 106-114

Published online September 30, 2023

© Korean Society of Cancer Prevention

Effectiveness and Safety of Apatinib Plus Programmed Cell Death Protein 1 Blockades for Patients with Treatment-refractory Metastatic Colorectal Cancer: A Retrospective Exploratory Study

Shenglong Li1,* , Hao Zheng1,* , Qinghong Ge2 , Shuli Xia1 , Ke Zhang1 , Chunjing Wang1 , Fujing Wang1

1Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, 2Department of Internal Medicine, Harbin Orthopedics Hospital, Harbin, China

Correspondence to :
Fujing Wang, E-mail:,
*These authors contributed equally to this work as co-first authors.

Received: February 27, 2023; Revised: June 21, 2023; Accepted: August 21, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study aimed to investigate the efficacy and safety of apatinib plus programmed cell death protein 1 (PD-1) blockades for patients with metastatic colorectal cancer (CRC) who were refractory to the standard regimens. In this retrospective study, patients with metastatic CRC who received apatinib plus PD-1 blockades in clinical practice were included. The initial dosage of apatinib was 250 mg or 500 mg, and PD-1 blockades were comprised of camrelizumab, sintilimab and pembrolizumab. Efficacy and safety data were collected through the hospital’s electronic medical record system. From October 2018 to March 2022, a total of 43 patients with metastatic CRC were evaluated for efficacy and safety. The results showed an objective response rate of 25.6% (95% CI, 13.5%-41.2%) and a disease control rate of 72.1% (95% CI, 56.3%-84.7%). The median progression-free survival (PFS) of the cohort was 5.8 months (95% CI, 3.81-7.79), and the median overall survival (OS) was 10.3 months (95% CI, 5.75-14.85). The most common adverse reactions were fatigue (76.7%), hypertension (72.1%), diarrhea (62.8%), and hand-foot syndrome (51.2%). Multivariate Cox regression analysis revealed that Eastern Cooperative Oncology Group (ECOG) performance status and location of CRC (left or right-side) were independent factors to predict PFS of patients with metastatic CRC treated with the combination regimen. Consequently, the combination of apatinib and PD-1 blockades demonstrated potential efficacy and acceptable safety for patients with treatment-refractory metastatic CRC. This conclusion should be confirmed in prospective clinical trials subsequently.

Keywords: Metastatic colorectal cancer, Apatinib, Programmed cell death protein 1 blockades, Efficacy, Safety

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