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Updated: Aug 9, 2026
Practical Considerations in Studying Metastatic Lung Colonization in Osteosarcoma Using the Pulmonary Metastasis Assay
Published on: March 12, 2018
A case report of apatinib in treating osteosarcoma with pulmonary metastases
Yong Zhou1, Wengeng Zhang, Fan Tang
1Department of Orthopedics Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Rationale:
Osteosarcoma is the most common malignant bone tumor in children and adolescents. Pulmonary metastases lead to a significantly increased risk of death. Apatinib, a new potent oral small-molecule tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor 2 (VEGFR-2), shows survival benefits in treating advanced or metastatic gastric adenocarcinoma, non-squamous non-small cell lung cancer and metastatic breast cancer. However, its efficacy in metastatic osteosarcoma has not been reported yet.
Patient Concerns:
Herein, we presented a 50-year-old man patient who visited hospital due to local bone pain in the left leg.
Diagnoses:
He was initially diagnosed with osteoblastic osteosarcoma.
Interventions:
The patient suffered repeated resection surgeries but developed multiple lung metastases. Positive staining for CD31, CD34, and VEGFR-2 were detected in the tumor section. As he refused to receive chemotherapy due to concerns regarding the chemotherapy toxicities and sorafenib due to high cost, apatinib was given at a dose of 500 mg daily.
Outcomes:
Eleven months following apatinib administration, the patient achieved a partial response according to the RECIST 1.1 standard. No severe toxicity or drug-related side effect was observed during the treatment.
Lessons:
Therefore, apatinib could be a new option for the treatment of metastatic osteosarcoma. Clinical trials are required to further confirm the efficacy and safety of apatinib in treating pulmonary metastases from osteosarcoma.
Insights
Apatinib shows promise in treating metastatic osteosarcoma, a rare cancer. This tyrosine kinase inhibitor demonstrated a partial response in a patient with lung metastases, with no severe side effects observed.
Area of Science:
- Oncology
- Pharmacology
Background:
- Osteosarcoma is a common bone cancer in children and adolescents, with pulmonary metastases significantly increasing mortality.
- Apatinib, a vascular endothelial growth factor receptor 2 (VEGFR-2) inhibitor, has shown efficacy in other advanced cancers.
Observation:
- A 50-year-old male patient with osteoblastic osteosarcoma developed multiple lung metastases after repeated surgeries.
- The patient received apatinib due to refusal of chemotherapy and high cost of sorafenib, showing positive VEGFR-2 staining in tumors.
Findings:
- Apatinib treatment resulted in a partial response (RECIST 1.1) over 11 months.
- No severe toxicity or drug-related side effects were noted during apatinib therapy.
Implications:
- Apatinib may represent a novel therapeutic option for metastatic osteosarcoma.
- Further clinical trials are necessary to validate the efficacy and safety of apatinib in osteosarcoma pulmonary metastases.
