Efficacy and safety of apatinib in treatment of osteosarcoma after failed standard multimodal therapy

Tian, Zhichao; Gu, Zhiyuan; Wang, Xin; Liu, Zhiyong; Yao, Weitao; Wang, Jiaqiang; Zhang, Peng; Cai, Qianqian; Ge, Hong

doi:10.1097/md.0000000000015650

Cited by 20 publications

(13 citation statements)

References 41 publications

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“…No treatment-related deaths were observed. The PR rate in this trial was significantly higher than that reported by retrospective studies ( 42 , 43 ). It may be due to the high dose of apatinib, which was 750 mg per day in the registered trial, compared with 500 mg per day in retrospective studies.…”

Section: Tkis Reported In Registered Clinicaltrials For Osteosarcoma contrasting

confidence: 78%

Receptor Tyrosine Kinases in Osteosarcoma Treatment: Which Is the Key Target?

2020

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Recent clinical trials have shown several multi-target tyrosine kinase inhibitors (TKIs) to be effective in the treatment of osteosarcoma. However, these TKIs have a number of targets, and it is yet unclear which of these targets has a key role in osteosarcoma treatment. In this review, we first summarize the TKIs that were studied in clinical trials registered on ClinicalTrials.gov. Further, we compare and discuss the targets of these TKIs. We found that TKIs with promising therapeutic effect for osteosarcoma include apatinib, cabozantinib, lenvatinib, regorafenib, and sorafenib. The key targets for osteosarcoma treatment may include VEGFRs and RET. The receptor tyrosine kinases (RTKs) MET, IGF-1R, AXL, PDGFRs, KIT, and FGFRs might be relevant but unimportant targets for osteosarcoma treatment. Inhibition of one type of RTK for the treatment of osteosarcoma is not effective. It is necessary to inhibit several relevant RTKs simultaneously to achieve a breakthrough in osteosarcoma treatment. This review provides comprehensive information on TKI targets relevant in osteosarcoma treatment, and it will be useful for further research in this field.

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Section: Tkis Reported In Registered Clinicaltrials For Osteosarcoma contrasting

confidence: 78%

Receptor Tyrosine Kinases in Osteosarcoma Treatment: Which Is the Key Target?

2020

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“…As a multitarget TKI marketed for the treatment of advanced or metastatic gastric cancer in China, apatinib has been shown to be effective for the treatment of osteosarcoma. In our previous work, we found that the incidence of pneumothorax in patients with osteosarcoma treated with apatinib was 18.18%-31.58% [10,11]. which was similar to the results of other studies [5,12].…”

Section: Introductionsupporting

confidence: 90%

Secondary pneumothorax as a potential marker of apatinib efficacy in osteosarcoma: a multicenter analysis

Tian

Yang

Gao

et al. 2020

Preprint

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Background Studies have shown that apatinib is effective for treatment of osteosarcoma. However, pneumothorax is a major adverse event associated with treatment of osteosarcoma with apatinib. This study was performed to investigate pneumothorax characteristics and association with clinical outcomes in patients with osteosarcoma treated with apatinib. Methods We retrospectively reviewed the medical records of osteosarcoma patients treated with apatinib between January 2016 and April 2020 at three institutions. We evaluated the prevalence, healing time, recurrence, severity, clinical management, and prognosis of pneumothorax in these patients. Results A total of 54 osteosarcoma patients who received apatinib treatment were enrolled in this study. Among them, 14 patients had pneumothorax. There were significant differences between the patients with and without pneumothorax with regard to the cavitating rate of lung metastases (92.86% vs 32.50%, respectively, p < 0.001), objective response rate (42.86% vs 10.00%, p = 0.013), disease control rate (85.71% vs 42.50%, p = 0.006), 4-month progression-free survival (PFS) rate (57.10% vs 20.00%, p < 0.001), and median PFS (5.65 months vs 2.90 months, p = 0.011). Conclusions Pneumothorax and cavitation in lung metastases may be effective prognostic markers for patients with osteosarcoma treated with apatinib.

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“…All TKIs with promising preclinical and clinical effectiveness against sarcoma, including apatinib, anlotinib, axitinib, imatinib, pazopanib, regorafenib, sorafenib, and sunitinib, target multiple angiogenic and growth-promoting receptor tyrosine kinases, as shown in Table 7. Apatinib and anlotinib, the only two domestically developed multi-target TKIs, have been marketed and used widely for the treatment of advanced sarcomas in China [17,18,21]. Although many clinical studies of apatinib and anlotinib have begun to recruit patients with sarcoma (http://www.chictr.org.cn), this study is the first to simultaneously investigate the effectiveness and safety of these two drugs in patients with advanced sarcomas.…”

Section: Discussionmentioning

confidence: 99%

Retrospective review of the activity and safety of apatinib and anlotinib in patients with advanced osteosarcoma and soft tissue sarcoma

et al. 2020

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Summary Background Previous studies have demonstrated the efficacy of apatinib and anlotinib for the treatment of sarcomas. However, more clinical data and evidence are needed to support clinical treatment selection and study design. Here, we evaluated the effectiveness and safety of these two drugs for the treatment of sarcomas. Methods We retrospectively reviewed the data of 110 patients with advanced osteosarcoma (n = 32) or soft tissue sarcoma (STS, n = 78) who received oral apatinib or anlotinib therapy during May 2016–February 2019 at two centers. Patients were divided into the apatinib and anlotinib groups. Results Among osteosarcoma patients, the objective response rates (ORRs) for the apatinib and anlotinib groups were 15.79% (3/19) and 7.69% (1/13), respectively. The disease control rates (DCRs) were 63.16% (12/19) and 30.77% (4/13), and the median progression-free survival (m-PFS) was 4.67 ± 3.01 and 2.67 ± 1.60 months, respectively. Among STS patients, ORRs for the apatinib and anlotinib groups were 12.24% (6/49) and 13.79% (4/29), respectively. The DCRs were 59.18% (29/49) and 55.17% (16/29), and m-PFS was 7.82 ± 6.90 and 6.03 ± 4.50 months, respectively. Regarding adverse events (AEs), apatinib was associated with a higher incidence of hair hypopigmentation and pneumothorax, while anlotinib was associated with a higher incidence of pharyngalgia or hoarseness. Conclusion Both apatinib and anlotinib were effective for the treatment of sarcomas. However, the effectiveness of the two drugs and associated AEs varied based on the histological type of sarcoma. These differences may be due to their different sensitivities to targets such as RET, warranting further study.

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Efficacy and safety of apatinib in treatment of osteosarcoma after failed standard multimodal therapy

Cited by 20 publications

References 41 publications

Receptor Tyrosine Kinases in Osteosarcoma Treatment: Which Is the Key Target?

Receptor Tyrosine Kinases in Osteosarcoma Treatment: Which Is the Key Target?

Secondary pneumothorax as a potential marker of apatinib efficacy in osteosarcoma: a multicenter analysis

Retrospective review of the activity and safety of apatinib and anlotinib in patients with advanced osteosarcoma and soft tissue sarcoma

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