Apatinib in advanced alveolar soft part sarcoma: Evidence of efficacy and safety.

e23521 Background: Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma with high metastatic potential and poor prognosis, and it mainly affects young patients. As ASPS is resistance to chemotherapy, antiangiogenic agent sunitinib is the only therapeutic option recommended by NCCN Guidelines Version 2017. Previous studies have suggested that apatinib, an oral VEGFR-2 inhibitor, is safe and effective in some sarcomas. The aim of this study was to evaluate the efficacy and safety of apatinib for advanced ASPS. Methods: This retrospective series analyzed 6 advanced ASPS patients who received apatinib from 2015 to 2017 at West China Hospital, Sichuan University. Among the 6 patients, there were 1 patient with unresectable local tumor and 5 patients with multiple unresectable lung metastases. Apatinib 500mg was administered once daily. Five of the 6 patients had no previous exposure to other antiangiogenic agents. Tumor responses were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Toxicities were also evaluated according to the National Cancer Institute Common Toxicity Criteria version 4.0 (CTC4.0). Results: The mean age of the six patients was 26±5 years old. Until Nov. 6 2017, 4 patients continued using apatinib, 1 patients stopped because of CR, the other patient stopped because of surgery. The median dosing time was 8.8 months (4.5-11.93 months). Of the 6 patients, 1 patient achieved complete response and 5 patients achieved partial response. The clinical benefit was recorded in total 6 patients, the objective response rate and disease control rate are both 100%. The common adverse events were as follows: hand-foot syndrome (66.7%), diarrhea (50%), grey hair (33.3%), hypertension (16.7%) and albuminuria (16.7%). There were no grade 3/4 adverse events. No patients experienced dosage reduction. Conclusions: Apatinib showed promising antitumor activity in patients with ASPS with tolerated adverse effects, when treated as first-line or second line treatment.