Objective To investigate the efficacy and safety of apatinib combined with capecitabine and temozolomide in the treatment of metastatic gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN).Methods Twenty-eight patients with metastatic GEP-NEN admitted and and treated in this hospital from January 2020 to June 2023 were selected as the study subjects and divided into the experimental group(n=13)and control group(n=15)according to different treatment regimens.The experiment group was given apatinib combined with capecitabine and temozolomide.The control group was given capecitabine and temozo-lomide.The medication lasted until the disease progression(PD)or adverse reactions were intolerable.The main observation indicators were the median progression-free survival(PFS)time.The secondary endpoints included the objective response rate(ORR),disease control rate(DCR)and adverse reactions.Results The experimental group had 0 case of complete remission(CR),6 cases of partial remission(PR),4 cases of stable disease(SD)and 3 cases of PD.ORR and DCR were 46.15％and 76.92％respectively,and the median PFS was 10.8 months.The control group had 0 case of CR,5 cases of PR,4 cases of SD and 6 cases of PD.ORR and DCR were 33.33％and 60.00％respectively,and the median PFS was 9.2 months.PFS in the experiment group was prolonged by 1.6 months than the control group.PD or death risk was decreased by 58％(HR=0.42,95％CI:0.19-0.93,P=0.009 4).The chemotherapeutic drug related adverse reactions in the experimental group occurred,meanwhile the anti-angiogenesis targeting drug related adverse reactions also occurred,but the adverse reactions in the two groups all were grade 1-2,which were tolerated after treatment.Conclusion Apatinib com-bined with capecitabine and temozolomide is effective and safe in the treatment of metastatic GEP-NEN.
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