The Use Of Apatinib Combined With Chemotherapy In Treating Soft Tissue Sarcoma.

e23524 Background: Soft tissue sarcomas (STS) are rare and aggressive malignancies that develop from the mesenchymal tissue. Despite advances in treatment methods, the prognosis of STS is very poor. Targets therapy combined with chemotherapy is very popular in recent years. Apatinib, a small molecule vascular endothelial growth factor receptor-2 (VEGFR-2) tyrosine kinase inhibitor, plays antiangiogenic and antitumor roles. Methods: Three patients of STS were treated with apatinib combined with chemotherapy from Feb. 2016 to Sep. 2016, as detailed in the Table. The dose of apatinib was 250mg/d. Chemotherapy regimen was ifosfamide combined with pirarubicin or gemcitabine combined with carboplatin/DDP. Next generation sequence (NGS) was used to test the gene change of tumor. Results: The characteristics of patients are shown in the Table, all patients show partial response to apatinib combined with chemotherapy. Moreover, the three patients have achieved progression-free survival of 14, 9 and 11 months, respectively, which were much better than previous reported (about 6 months). The main toxicities were tolerable. The gene test showed many genes change, which were members of tumor angiogenesis pathway, including AKT1, MAP2K2, KRAS and PIK3CA. Conclusions: The results of NGS showed that there were many tumor angiogenesis related genes change in STSs. Apatinib as VEGFR-2 TKI, combined with chemotherapy could prolong the PFS, improve the quality of life. Apatinib may provide an additional option for the treatment of STS. Characteristics Patient 1 Patient 2 Patient 3 Age, years 32 27 18 Sex Female Female Female Primary tumor position Left nose Right thigh Left cheek Pathologic type Fibromyxoid sarcoma Angiosarcoma Rhabdomyosarcoma Stage of treatment with apatinib Locally advanced Lung and brain metastasis Locally advanced Treatment line 1 Surgery Surgery Ifosfamide and pirarubicin + Apatinib Treatment line 2 Second surgery + chemotherapy Pazopanib Treatment line 3 Ifosfamide and pirarubicin + Apatinib Gemcitabine and carboplatin/DDP+Apatinib PFS of Apatinib 14 months 9 months 11 months