Anlotinib: A Novel Targeted Drug for Bone and Soft Tissue Sarcoma.

Shenglong Li

doi:10.3389/fonc.2021.664853

Abstract

Bone and soft tissue sarcomas account for approximately 15% of pediatric solid malignant tumors and 1% of adult solid malignant tumors. There are over 50 subtypes of sarcomas, each of which is notably heterogeneous and manifested by remarkable phenotypic and morphological variability. Anlotinib is a novel oral tyrosine kinase inhibitor (TKI) targeting c-kit, platelet-derived growth factor receptors, fibroblast growth factor receptor, and vascular endothelial growth factor receptor. In comparison with the placebo, anlotinib was associated with better overall survival and progression-free survival (PFS) in a phase III trial of patients with advanced non-small cell lung cancer (NSCLC), albeit with cancer progression after two previous lines of treatment. Recently, the National Medical Products Administration approved anlotinib monotherapy as a third-line treatment for patients with advanced NSCLC. Additionally, a phase IIB randomized trial substantiated that anlotinib is associated with a significant longer median PFS in patients with advanced soft tissue sarcoma. Moreover, anlotinib is also effective in patients with advanced medullary thyroid carcinoma and metastatic renal cell carcinoma. Anlotinib has similar tolerability to other TKIs targeting vascular endothelial growth factor receptors and other tyrosine kinase-mediated pathways. However, anlotinib has a notably lower rate of side effects ≥grade 3 relative to sunitinib. This review discussed the remarkable characteristics and major dilemmas of anlotinib as a targeted therapy for sarcomas.

Highlights

Bone and soft tissue sarcoma (STS) is a class of tumors in the leaf system, including primary malignant bone tumor and STS [1, 2], accounting for approximately 1% of adult and 15% of pediatric malignant tumors [3]
In comparison with anlotinib or DDP only, anlotinib combined with DDP notably reduced tumor weight and volume in vivo [56]. These results revealed that anlotinib increased the in vivo and in vitro sensitivity of osteosarcoma cells to DDP
The results revealed that the median progression-free survival (PFS) of anlotinib-treated patients was similar to that of patients who received no or one previous treatment (6.70 vs. 6.33 months, respectively)

Summary

Introduction

Bone and soft tissue sarcoma (STS) is a class of tumors in the leaf system, including primary malignant bone tumor and STS [1, 2], accounting for approximately 1% of adult and 15% of pediatric malignant tumors [3]. As encouraged by the inhibitory effects of anlotinib on a variety of cancer cells, potential in vivo anti-tumor activity has been studied using anlotinib alone or in combination with chemotherapy in human xenograft tumor models of multiple cancers [55,56,57].

Results

Conclusion