title: A case report of apatinib in treating osteosarcoma with pulmonary metastases.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Herein, we presented a 50-year-old man patient who visited hospital due to local bone pain in the left leg.
  
  
  METHODS
  He was initially diagnosed with osteoblastic osteosarcoma.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopedics Precision Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.forename: Wengeng
authors.initials: W
authors.lastname: Zhang
authors.forename: Fan
authors.initials: F
authors.lastname: Tang
authors.forename: Yi
authors.initials: Y
authors.lastname: Luo
authors.forename: Li
authors.initials: L
authors.lastname: Min
authors.forename: Wenli
authors.initials: W
authors.lastname: Zhang
authors.forename: Rui
authors.initials: R
authors.lastname: Shi
authors.forename: Hong
authors.initials: H
authors.lastname: Duan
authors.forename: Chongqi
authors.initials: C
authors.lastname: Tu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005266:Femoral Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000188:drug therapy* / Q000556:secondary; D011725:Pyridines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011725:Pyridines; C553458:apatinib