Abstract
BackgroundOsteosarcoma is a relatively rare malignant tumor with a high incidence in young people. The development of tyrosine kinase inhibitors has brought the treatment of osteosarcoma into a new stage. Apatinib, a tyrosine kinase inhibitor specifically targeting VEGFR2, has been increasingly reported as a treatment for osteosarcoma with promising outcome parameters, but there has been no systematic analysis of the treatment of osteosarcoma by apatinib.MethodsA single-arm meta-analysis was performed, and published literature from PubMed, Web of Science, Embase, Cochrane Library, CNKI and Wan Fang databases as of March 1, 2021 was systematically retrieved. Quality assessment is carried out in accordance with a 20 item checklist form prepared by the Institute of Health Economics (IHE). Double arcsine transformation is performed to stabilize the variance of the original ratio. When I2 > 50%, the random effect model is used to calculate the pooled parameters; otherwise, the fixed effect model is used. We conducted subgroup analysis according to age and apatinib dose.ResultsThis meta-analysis included 11 studies of 356 Chinese patients with osteosarcoma. The pooled objective remission rate (ORR) of advanced or metastatic osteosarcoma treated by oral apatinib in Chinese patients was 0.27(95%CI = 0.18–0.38). The pooled disease control rate (DCR) was 0.57 (95%CI = 0.42–0.72). The pooled median progression-free survival (mPFS) and median total survival (mOS) were 5.18 months (95%CI = 4.03–6.33) and 10.87 months (95% CI = 9.40–12.33), respectively. More than 70% of adverse reactions were mild, the most common adverse reaction was hand-foot syndrome (HFMD), with an incidence of 0.46 (95%CI = 0.35–0.58), the second was hypertension, with an incidence of 0.40 (95%CI = 0.29–0.51).ConclusionsThe efficacy of apatinib in the treatment of osteosarcoma is competitive with current evidence, and it is worth noting that its low cost can significantly improve patient compliance and increase therapeutic value.
Highlights
Osteosarcoma is a relatively rare malignancy that occurs mostly in children and adolescents, with an incidence of about 3 per million persons every year in China [1]
A total of 11 studies involving 356 Chinese patients with osteosarcoma were eventually included in this meta-analysis [25,26,27,28,29,30,31,32,33,34,35]
The incidence of lung metastasis reported in this study was as high as 90–100%, and the significantly higher incidence level may be related to the fact that all the patients in this study were patients with advanced or metastatic osteosarcoma
Summary
Osteosarcoma is a relatively rare malignancy that occurs mostly in children and adolescents, with an incidence of about 3 per million persons every year in China [1]. Previous studies have shown that tyrosine kinase inhibitors such as geffitinib, sorafenib and apatinib show promising potential in inhibiting metastasis and invasion of osteosarcoma [12,13,14]. A small molecule targeted anti-angiogenesis drug, was approved in China in 2014 for the treatment of advanced gastric cancer and has shown good safety and efficacy [15]. Osteosarcoma is a relatively rare malignant tumor with a high incidence in young people. The development of tyrosine kinase inhibitors has brought the treatment of osteosarcoma into a new stage. A tyrosine kinase inhibitor targeting VEGFR2, has been increasingly reported as a treatment for osteosarcoma with promising outcome parameters, but there has been no systematic analysis of the treatment of osteosarcoma by apatinib
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