Ovarian cancer is a most common lethal gynecological malignant tumor, with a gradual increasing incidence throughout the world. The mainstay treatment is cytoreductive surgery followed by platinum-based chemotherapy. However, a high percentage of patients recur, thus needing multiple treatments with a frequently poor prognosis. Apatinib is a novel and highly selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2. Previous studies have suggested that apatinib is safe and effective in some solid tumors. We report one case with platinum-resistant advanced epithelial ovarian cancer, who had failed prior treatment with multiple chemotherapy reagents. She was negative for multiple driver genes including BRCA1/2、EGFR、KRAS/NRAS/BRAF, ALK, HER2 and cMET. Five courses of apatinib plus epirubicin were given. Due to the heavy leukothrombopenia, apatinib monotherapy, at 250 mg qd dose level, was used for maintenance therapy. The progression-free survival (PFS) time was 12.6 months. After that, the disease was slightly progressive during apatinib maintenance and then entered into a "stable" state until now. It indicated that apatinib may be a superior choice for advanced ovarian cancer patients, but further prospective studies are needed to optimize the treatment.
Keywords: Advanced ovarian cancer; apatinib; maintenance therapy; platinum-resistant; progression-free survival; vascular endothelial growth factor.