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Observational Study
. 2018 Aug;97(31):e11734.
doi: 10.1097/MD.0000000000011734.

Efficacy and safety of apatinib in advance osteosarcoma with pulmonary metastases: A single-center observational study

Kai Zheng  1 , Ming Xu, Lei Wang, Xiuchun Yu
Affiliations
Observational Study

Efficacy and safety of apatinib in advance osteosarcoma with pulmonary metastases: A single-center observational study

Kai Zheng et al. Medicine (Baltimore). 2018 Aug.

Abstract

This study was designed to evaluate the efficacy and safety of apatinib in patients with advanced osteosarcoma and pulmonary metastases following failed first-line chemotherapy.There were 10 patients with osteosarcoma pulmonary metastases, whose first-line chemotherapy had failed, had received apatinib treatment as a single agent. All patients had at least 1 measurable lung tumor. Progression free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse effects (AEs) were reviewed and evaluated. Tumor response was assessed by response evaluation criteria in solid tumor criteria (RECIST). The 10 patients in this study received apatinib treatment for 2 to 16 months with a median of 7.5 months. The median PFS was 7.5 months. The 6-month, 8-month, and 10-month PFS rates were 60%, 40% and 26.6%, respectively. The median OS was 14 months. After 6-month apatinib treatment, 2 patients achieved partial response and 5 patients achieved stable disease, while 3 patients were evaluated as progression of the disease. At the 6-month follow-up, the ORR was 20.0% and the DCR was 70.0%. Hand-foot syndrome with grade 1/2 was the most common treatment-related AE. No drug-related severe AEs occurred.After failed first-line chemotherapy, apatinib as a single agent exhibited efficacy and acceptable safety in patients with advanced osteosarcoma and pulmonary metastases.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Immunochemical staining analysis of VEGFR2 in available tissue was performed before apatinib therapy. (A) Absence of expression of VEGFR2. (B) Weak expression of VEGFR2. (C and D) Moderate expression of VEGFR2. VEGFR-2 = vascular endothelia growth factor receptor-2.
Figure 2
Figure 2
Efficacy evaluation of apatinib in patients with advance osteosarcoma and pulmonary metastases. (A) PFS curve in these patients. (B) OS curve in these patients. PFS = progression free survival.
Figure 3
Figure 3
The tumor change of pulmonary metastases at 6 months after apatinib treatment.
Figure 4
Figure 4
Image illustrating tumor changes of 1 PR patient with lung metastatic osteosarcoma. (A) The chest CT shows large pulmonary metastases in the left lung. (B) Two months later after apatinib treatment. (C) Interruption of apatinib treatment for 1 month. (D) The patient's apatinib treatment recovery, the tumor achieved PR again.
Figure 5
Figure 5
The chest CT shows the lesion replaced by a vacuole after apatinib treatment for 2 months.
See this image and copyright information in PMC

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