Shi JF, Xu H, Gao JF, Wu JB. Adjuvant irinotecan-apatinib therapy for recurrent/metastatic gastric cancer after surgery: A real-world evaluation. World J Gastrointest Surg 2026; 18(3): 114569 [DOI: 10.4240/wjgs.v18.i3.114569]
Corresponding Author of This Article
Jian-Bin Wu, MD, Department of Human Resources, Jiangsu Hengrui Medicine Co., Ltd, No. 1288 Haike Road, Shanghai 200122, China. 18205137866@163.com
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Gastroenterology & Hepatology
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Retrospective Study
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Mar 27, 2026 (publication date) through Mar 30, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Shi JF, Xu H, Gao JF, Wu JB. Adjuvant irinotecan-apatinib therapy for recurrent/metastatic gastric cancer after surgery: A real-world evaluation. World J Gastrointest Surg 2026; 18(3): 114569 [DOI: 10.4240/wjgs.v18.i3.114569]
World J Gastrointest Surg. Mar 27, 2026; 18(3): 114569 Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.114569
Adjuvant irinotecan-apatinib therapy for recurrent/metastatic gastric cancer after surgery: A real-world evaluation
Jun-Feng Shi, Hui Xu, Jin-Feng Gao, Jian-Bin Wu
Jun-Feng Shi, Department of Oncology, Nanjing First Hospital, Nanjing 210006, Jiangsu Province, China
Hui Xu, Department of Oncology, Nanjing Lishui District People’s Hospital, Nanjing 211200, Jiangsu Province, China
Jin-Feng Gao, Department of Oncology, Nanjing Jiangbei Hospital, Nanjing 210000, Jiangsu Province, China
Jian-Bin Wu, Department of Human Resources, Jiangsu Hengrui Medicine Co., Ltd, Shanghai 200122, China
Author contributions: Wu JB designed the research and wrote the first manuscript; Shi JF, Xu H, Gao JF and Wu JB contributed to conceiving the research and analyzing data; Wu JB conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Institutional review board statement: The study was approved by the Institutional Review Board of Nanjing First Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors state that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Corresponding author: Jian-Bin Wu, MD, Department of Human Resources, Jiangsu Hengrui Medicine Co., Ltd, No. 1288 Haike Road, Shanghai 200122, China. 18205137866@163.com
Received: November 18, 2025 Revised: December 22, 2025 Accepted: January 12, 2026 Published online: March 27, 2026 Processing time: 129 Days and 3.6 Hours
Abstract
BACKGROUND
The S-1+oxaliplatin regimen shows limited efficacy in postoperative recurrent/metastatic gastric cancer (RMGC) treatment, requiring adjuvant therapy optimization to enhance effectiveness.
AIM
To clarify how adjuvant irinotecan-apatinib therapy works in postsurgical RMGC management using real-world data.
METHODS
We enrolled 124 postoperative RMGC cases (April 2021 to April 2024) and allocated them to the control (n = 60, sole irinotecan) and research (n = 64, irinotecan + apatinib) groups. All participants received intravenous S-1 infusion and oral oxaliplatin administration. Between-group comparisons were made regarding effectiveness, inflammation-associated parameters [vascular endothelial growth factor, matrix metalloproteinase (MMP)-2, MMP-9], serum tumor biomarkers [carbohydrate antigen (CA) 242, CA199, carcinoembryonic antigen], and treatment-emergent adverse events (thrombocytopenia, hemoglobin reduction, nausea/vomiting, myelosuppression). Assessments were further extended to survival and life quality outcomes Generic Quality of Life Inventory-74 (GQOLI-74).
RESULTS
The between-group comparison revealed similar effectiveness, overall complications, and survival outcomes. The research group demonstrated greater post-treatment reductions in inflammatory markers and serum tumor biomarkers and achieved higher scores across all GQOLI-74 dimensions.
CONCLUSION
In real-world postoperative RMGC management, irinotecan-apatinib therapy achieves non-inferior antitumor efficacy, tolerability, and survival relative to irinotecan and more effectively attenuates inflammation, reduces serum tumor biomarkers, and improves quality of life.
Core Tip: This study presents a real-world data analysis of clinical efficacy outcomes associated with irinotecan-apatinib adjuvant therapy among patients with postoperative recurrent/metastatic gastric cancer (RMGC). We included 124 postsurgical RMGC patients treated from April 2021 to April 2024, all of whom received the S-1 (via intravenous infusion) plus oxaliplatin (via oral administration; S-1+oxaliplatin) regimen. The irinotecan-apatinib adjuvant therapy for these patients demonstrated significant clinical advantages in inhibiting inflammation and serum tumor markers while improving quality of life, which could be a better option for these patients.
