Association of Apatinib and Breast Cancer: A systematic review and meta-analysis

Background: Breast cancer (BC) is a common malignant tumor. Apatinib in combination with other treatments has been used for BC; however, its safety and efficacy are not well-known. Therefore, this meta-analysis was performed to assess the efficacy and safety of apatinib in the treatment of BC. Methods: Studies comparing the effects of apatinib-based therapy versus control among BC patients were included. On January 21, 2022, a systematic search was performed in 9 databases. The risk ratio (RR) with 95% confidence interval (CI) was used to estimate efficacy and safety. The I square value (I2) was used to assess heterogeneity. A leave-one-out sensitivity analysis was also conducted. Publication bias was assessed by funnel plots and Egger's and Begg's tests. Results: A total of 31 studies including 2,258 BC patients were included. The results showed that apatinib group had a significant improvement in disease control rate (DCR, RR = 1.43, 95% CI = 1.35-1.52, I-2 = 43.8%) and objective response rate (ORR, RR = 1.79, 95% CI = 1.51-2.13, I-2 = 61.8%) compared to the control group. Except for hemorrhage, hypertension, and hand-foot syndrome, the adverse events were similar between apa-tinib group and control group. Subgroup analyses found statistically significant differences in DCR in all sub-groups except for apatinib combined with radiation therapy and with paclitaxel liposome plus S1. For ORR, there were statistically significant differences in all subgroups except for the radiation therapy, and apatinib mono -therapy subgroups. Conclusions: Our study shown apatinib showed good efficacy and acceptable safety in the treatment of BC pa-tients. More high-quality randomized controlled trials from different regions and countries are needed to confirm our findings.