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

Inclusion Criteria: 1. Patients with histologically proven primary locally advanced or metastatic gastric or gastroesophageal junction adenocarcinoma; 2. Age ≥ 65 years; 3. ECOG Performance Status: 0-2; 4. No previous anti-cancer therapy for the locally advanced or metastatic disease; 5. Unable or unwilling to chemotherapy; 6. At least one measurable lesion as defined by RECIST 1.1; 7. With acceptable hematologic, cardiac, hepatic, pulmonary and renal function; 8. Can take apatinib orally; 9. Life Expectancy: 3 months or more. Exclusion Criteria: 1. History of other primary malignancy (except basal cell skin cancer or cervical carcinoma in situ); 2. Patients with un-controlled blood pressure on medication (\> 140/90 mmHg); 3. Patients with other nonmeasurable disease such as un-controlled diabetes, severe cardiovascular and cerebrovascular diseases; 4. Patients with bleeding tendency, receiving thrombolytics or anticoagulants； 5. Patients with massive hydrothorax or ascites; 6. Patients with uncontrolled central nervous system (CNS) metastases; 7. Proteinuria 2+ or 24-hour urinary protein ≥ 1g; 8. History of drug addiction or abuse; 9. Patients cannot take apatinib orally for any reason; 10. Estimated life expectancy ˂ 3 months; 11. Current, recent (within 4 weeks prior to study entry), or planned participation in any other clinical trials; 12. Inability to understand and agree to informed consent.