Apatinib for epithelioid sarcoma: analysis on eight advanced stage cases in a single institute.

Abstract

e22551 Background: Epithelioid sarcoma (ES) is a rare high grade soft tissue sarcoma with high incidence of lymph node involvement and distant metastasis. It is widely recognized that ES is not sensitive to chemotherapy and radiation, surgical treatment is the only curative option for localized diseases. Tyrosine kinase inhibitors (TKIs) has been proven to be effective in sarcomas, here we report the experience of Apatinib in 8 advanced ES cases. Methods: ES patients treated in Fudan University Shanghai Cancer Center from Dec, 2016 to Aug, 2018 were accrued retrospectively. Those with locally advanced diseases or distant metastasis were treated with orally Apatinib 500mg, daily use for at least 2 months. Assessment of efficacy and side effects were recorded every 2 months and patients were then treated according to reponses to Apatinib. Results: There were 8 patients with locally advanced or late stage ES in a total 20 ES patients during the study period. There were 6 males and 2 females with median age of 55 years (20-73). 3 of the 8 were classical type and 5 were proximal type. 7 of the 8 patients were locally advanced and 1 was with lung metastasis at diagnosis. 4 of the 8 had a partial response to Apatinib and one patient has a downstaged ES which was surgically removed. The other 4 had a stable disease to Apatinib but 2 were not able to tolerate side effects and stopped at first evaluation, the other 2 remains progression free. Main side effects included skin rash, hypertension and diarrhea. Hypertension was the only Grade 3-4 side effect. With median follow-up of 12 months, 6 remains progression free, the 2 patients who didn’t tolerate side effects and stopped Apatinib developed lung metastasis. Conclusions: Apatinib has unproven but promising effect in ES, TKI is an option especially for those not sensitive to cytotoxic agents and radiation.