Published online Apr 6, 2020. doi: 10.12998/wjcc.v8.i7.1326
Peer-review started: December 17, 2019
First decision: February 20, 2020
Revised: March 5, 2020
Accepted: March 10, 2020
Article in press: March 10, 2020
Published online: April 6, 2020
Apatinib is a small-molecule multitargeted tyrosine kinase inhibitor. Apatinib has demonstrated encouraging antitumor activities. This study aimed to observe the efficacy and safety of apatinib for the treatment of multiple brain micrometastases.
We report two patients with multiple brain micrometastases after failure of second-line treatment. Both patients had extracerebral metastases. When the patients took 250 mg/d apatinib orally, the intracerebral lesions disappeared. The extracerebral lesions were partially alleviated. Both patients had a progression-free survival of more than 12 mo and were still stable. The safety was good. The main adverse events (AEs) were mild hypertension and proteinuria, which could be controlled.
Apatinib has clear efficacy and good tolerance in patients with multiple brain micrometastases after failure of second-line treatment.
Core tip: Brain metastases are the most common intracranial tumor, and the average survival time of patients with brain metastases after symptomatic treatment with chemotherapy, radiotherapy, and hormonal drugs is less than 1 year. We report two patients with multiple brain micrometastases after failure of second-line treatment; both had extracerebral metastases. When the patients were treated with apatinib, the intracerebral lesions disappeared, and the extracerebral lesions were partially alleviated. Both patients had a progression-free survival of more than 12 mo and were still stable. Apatinib, a small-molecule oral inhibitor with anti-angiogenic function, may be an option for treating brain metastases.