Management of Apatinib-Related Adverse Events in Patients With Advanced Osteosarcoma From Four Prospective Trials: Chinese Sarcoma Study Group Experience

Frontiers in Oncology

Jing Chen¹  Zengwu Shao¹  Di Wu²  Sujia Wu³  Zhongqi Tu⁴  Xiaojing Zhang⁵  Yang Yao⁶  Jie Xu⁷  Lu Xie⁷  Wei Guo⁷  Jianhua Lin⁸  Xiuchun Yu⁹  Jianmin Li^1,10  Weibin Zhang^1,11  Jianru Xiao^1,12  Zhendong Cai^1,13  Yingqi Hua^1,13  Zhen Wang^1,14 

[1] 0Orthopedic Oncology and Medical Oncology, Wuhan Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China;1Medical Oncology, The First Affiliated Hospital of Jilin University, Changchun, China;2Orthopedic Oncology, General Hospital of Eastern Theater Command, Nanjing, China;3Orthopedic Oncology, Huaxi Hospital West China School of Medicine/West China Hospital of Sichuan University (WCSM/WCH), Chengdu, China;;4Musculoskeletal Tumor Center, Liaoning Cancer Hospital &Medical Oncology, Shanghai Sixth People’s Hospital, Shanghai, China;Musculoskeletal Tumor Center, Peking University People’s Hospital, Beijing, China;Musculoskeletal Tumor Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China;Orthopedic Oncology, Jinan Military General Hospital, Jinan, China;Orthopedic Oncology, Qilu Hospital of Shandong University, Jinan, China;Orthopedic Oncology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China;Orthopedic Oncology, Shanghai Changzheng Hospital, Shanghai, China;Orthopedic Oncology, Shanghai General Hospital, Shanghai, China;Orthopedic Oncology, Xijing Hospital Air Force Medical University of PLA (The Fourth Military Medical University), Xi’an, China;

关键词: apatinib;    toxicity;    prophylaxis;    treatment;    osteosarcoma;   

DOI  :  10.3389/fonc.2021.696865

来源: DOAJ

【 摘 要 】

Four prospective trials have reported apatinib-related efficacy in osteosarcoma, with a high response rate of 43.2%. Currently, Adverse Events (AEs) have increasingly gained attention, as treatment with multiple tyrosine kinase inhibitors (TKIs) is potentially lifelong. For this reason, a consensus meeting of the Chinese Sarcoma Study Group (CSSG), which is a multidisciplinary panel composed of pediatric, medical and surgical oncologists specializing in sarcoma, nurse specialists, oncological senior pharmacists and gastroenterologists, was held to develop comprehensive guidelines on AEs emerging due to apatinib treatment to better assist in the prevention, management, and understanding of AE development. We summarized all AEs that arose in ≥10% of the participants as well as rare AEs that required extra caution to prevent that were observed in these four published prospective trials and arranged these AEs into 14 disorder systems according to CTCAE 5.0. In this review, we discuss strategies for the management of AEs in patients with advanced osteosarcoma, with the aim of maximizing treatment benefits and minimizing the need for apatinib treatment discontinuation. We also focus on providing recommendations for the prophylaxis and treatment of advanced osteosarcoma using apatinib to achieve optimal outcomes.

【 授权许可】

Unknown