Apatinib as the First-Line Therapy in Elderly Locally Advanced or Metastatic Gastric Cancer

Inclusion criteria

• Patients with histologically proven primary locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma;
• Age ≥ 65 years;
• ECOG Performance Status: 0-2;
• No previous anti-cancer therapy for the locally advanced or metastatic disease;
• Unable or unwilling to chemotherapy;
• At least one measurable lesion as defined by RECIST 1.1;
• With acceptable hematologic, cardiac, hepatic, pulmonary and renal function;
• Can take apatinib orally;
• Life Expectancy: 3 months or more.

Exclusion criteria

• History of other primary malignancy (except basal cell skin cancer or cervical carcinoma in situ);
• Patients with un-controlled blood pressure on medication (> 140/90 mmHg);
• Patients with other nonmeasurable disease such as un-controlled diabetes, severe cardiovascular and cerebrovascular diseases;
• Patients with bleeding tendency, receiving thrombolytics or anticoagulants；
• Patients with massive hydrothorax or ascites;
• Patients with uncontrolled central nervous system (CNS) metastases;
• Proteinuria 2+ or 24-hour urinary protein ≥ 1g;
• History of drug addiction or abuse;
• Patients cannot take apatinib orally for any reason;
• Estimated life expectancy ˂ 3 months;
• Current, recent (within 4 weeks prior to study entry), or planned participation in any other clinical trials;
• Inability to understand and agree to informed consent.