Clinical Observation on Recombinant Human Endostatin Combined with Chemotherapy for Advanced Gastrointestinal Cancer

Objective: To explore the clinical efficacy and toxic and side effects of recombinant human endostatin (rhendostatin/endostar) combined with chemotherapy in the treatment of advanced gastric cancer. Materials and
Methods: A total of 70 patients with advanced gastrointestinal adenocarcioma confirmed by histopathology and/orcytological examination were divided into group A (37 patients) and group B (33 patients). Patients in group A weregiven intravenous drip of 15 mg endostar added into 500 mL normal saline, once every other day until the cessationof chemotherapy or patients’ maximal tolerance to chemotherapy. Patients in group B received chemotherapyalone. Two groups selected the same chemotherapy regimens. FOLFIRI scheme: 90-min intravenous drip of 180mg/m2  irinotecan, intravenous drip of 200 mg/m2 calcium folinate (CF) and 400 mg/m2 5-fluorouracil (5-Fu) ond1, and continuous intravenous pumping of 2 400 mg/m2 5-Fu for 46 h. FOLFOX4 scheme: intravenous injectionof 85 mg/m2 oxaliplatin (L-OHP), 200 mg/m2 calcium folinate (CF) and 400 mg/m2 5-FU on d1 for 2 h, and thencontinuous intravenous pumping of 2 400 mg/m2 5-Fu for 46 h. XELOX scheme: oral administration of 1 500mg/m2 xeloda (or tegafur 50~60 mg) in twice during d1~14 and intravenous drip of 135 mg/m2 L-OHP on d1 for2 h. The modified FOLFOX scheme: intravenous injection of 135 mg/m2 L-OHP on d1 for 2 h, 200 mg/m2 CFand 1.0 g tegafur during d1~5. Whereas, control Group B received chemotherapy regimens which were same asGroup A, but no addition of endostar. Before chemotherapy, patients were given intravenous injection of 8 mgondansetron, intramuscular injection of 10 mg metoclopramide and 20 mg diphenhydramine for prevention ofvomiting, protection of liver and stomach as well as symptomatic supportive treatment. One cycle was 21 d, 4~6cycles in total. The efficacy was evaluated every 2 cycles.
Results: 32 patients in Group A could be evaluated,and the response rate (RR) and disease control rate (DCR) were 59.38% and 78.13%, respectively. 31 patientsin Groups could be evaluated, and the RR and DCR were 32.26% and 54.84%, respectively. The differencesbetween 2 groups were significant. The toxic effects include myelosuppression, gastrointestinal reaction, fatigue,cardiotoxicity and peripheral neurotoxicity.
Conclusions: Preliminary observations show that endostar (onceevery other day) combined with chemotherapy is effective in the treatment of advanced gastrointestinal cancer,with low toxic effects, good tolerance, deserving further study.