title: A Case Report of Gastrointestinal Hemorrhage and Perforation During Apatinib Treatment of Gastric Cancer.
abstract: Apatinib is a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor-2, which shows good efficacy and safety in clinical trials for chemotherapy-refractory gastric cancer patients. Till now, there is no case report after apatinib came in the market. We presented a 55-year-old Chinese woman with advanced gastric cancer, who received apatinib after failure of second-line chemotherapy. On the 19th day of apatinib administration, she suffered from gastrointestinal hemorrhage. Then, her condition rapidly deteriorated to gastrointestinal perforation. Although the patient received timely medical and surgical treatment, she finally died of septic shock. Although apatinib shows exciting efficacy and good tolerance in phase II and III clinical trials, this novel targeted drug should be prescribed carefully and close clinical monitoring is needed when using it.
authors.affiliation: From the Department of Medical Oncology (X-FL, Y-NT, YC, YY); Department of Pathology (J-HX); and Key Laboratory of Cancer Prevention and Intervention of Ministry of Education, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (SZ, YY).
authors.forename: Xiao-Fen
authors.initials: XF
authors.lastname: Li
authors.forename: Yi-Nuo
authors.initials: YN
authors.lastname: Tan
authors.forename: Ying
authors.initials: Y
authors.lastname: Cao
authors.forename: Jing-Hong
authors.initials: JH
authors.lastname: Xu
authors.forename: Shu
authors.initials: S
authors.lastname: Zheng
authors.forename: Ying
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D018279:Carcinoma, Signet Ring Cell / Q000188:drug therapy* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D011725:Pyridines / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D011725:Pyridines; C553458:apatinib