Retrospective cohort study of efficacy and safety of neoadjuvant apatinib plus PD-1 inhibitor with SOX for locally advanced gastric cancer

Although neaodjuvant PD-1 inhibitors combined with chemotherapy are promising for locally advanced gastric cancer (LAGC), pathological complete response (pCR) rates remain suboptimal. A retrospective study in China avaluated addition of apatinib to neoadjuvant PD-1 inhibitor plus SOX chemotherapy. From a cohort of 449 patients, 1:1 propensity score matching was employed to yield 102 well-balanced pairs receiving either neoadjuvant PD-1 inhibitor plus apatinib plus SOX (PA-SOX) or PD-1 inhibitor plus SOX (P-SOX). The PA-SOX regimen demonstrated a significantly superior primary endpoint, achieving a pCR rate of 17.6%, compared with 6.9% in the P-SOX group (p=0.031), as well as higher major pathological response rate (38.2% versus 15.7%; p<0.001) and objective response rate (62.7% versus 33.3%; pxtagstartz0.001). PA-SOX also was associated with improved 2-year overall survival rate (82.4% versus 69.9%; HR 0.32; p=0.001) and 2-year disease-free survival rate (71.1% versus 41.7%; HR 0.35; p<0.001). Safety profiles were manageable. The authors conclude that addition of apatinib to neoadjuvant P-SOX was associated with improved outcomes among LAGC patients.