To evaluate the clinical efficacy of apatinib in three-line treatment of advanced gastric cancer and the change in serum vascular endothelial growth factor (VEGF) levels.

From January 2016 to December 2017, thirty patients with advanced gastric cancer who failed in first-line or second-line chemotherapy were treated with apatinib. The short-term and long-term effects and toxic side effects of patients were observed, and the changes of serum VEGF level before and after treatment were detected.

After 14.7 (8-22) weeks of oral administration of apatinib, 3 cases of complete remission (CR), 13 cases of partial remission (PR), 9 cases of disease stability (SD) and 5 cases of disease progression (PD), the effective rate was 53.3% (16/30), and the disease control rate was 83.3% (25/30). The median follow-up period was 8.6 (5-16) months. The median progression free survival (PFS) was 5.2 months (95% CI: 0-8.8 months), and the overall survival rate (OS) was 9.4 months (95% CI: 6.8-12.5 months). VEGF in serum decreased significantly after treatment (P<0.05). The degree of decline was more obvious in the patients with curative effect.

Apatinib has a definite clinical effect on patients with advanced gastric cancer who failed to receive first-line and second-line treatment, and can improve the quality of life of patients. The level of serum VEGF may reflect the therapeutic effect of apatinib to some extent.