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

Abstract

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.

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

“…To our knowledge, this study is the rst to focus on pneumothorax in osteosarcoma patients treated with apatinib. The results of this study showed that the incidence of pneumothorax in osteosarcoma patients treated with apatinib was 25.93%, which was similar to previous reports [5,11,12]. However, the incidence of pneumothorax in osteosarcoma patients treated with sorafenib and regorafenib, the other two multitarget TKIs that have been shown to be effective in osteosarcoma treatment, was 3% and 0%, respectively [4,6,7].…”

“…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].…”

In vitro studies of H520 cell cycle and apoptosis by anlotinib combined with radiotherapy

“…Another clinical implication of this finding is that the systemic therapeutic effect of anlotinib cannot substitute for the therapeutic effect of radiotherapy in local treatment. This result has also been confirmed by numerous clinical trials 13–15 …”

High cumulative doxorubicin dose for advanced soft tissue sarcoma

“…As a major sarcoma treatment center in central China, our institution has used high cumulative doses of doxorubicin in our clinical work to treat a number of patients with advanced STS, because of the lack of other effective treatment modalities [ 18 ]. In this study, we aimed to review and analyze the clinical data of these patients to provide a reference for treatment selection and clinical trial design for treating advanced STS.…”