A retrospective study on the efficacy and safety of anlotinib combined with limb salvage therapy for osteosarcoma after chemotherapy failure

This study aimed to evaluate the efficacy and safety of anlotinib combined with limb salvage therapy in patients with osteosarcoma after chemotherapy failure. A retrospective study was conducted on 46 eligible osteosarcoma patients who failed chemotherapy, admitted to our hospital from October 2021 to December 2022. They were divided into 2 groups: 28 patients in the anlotinib combined with limb salvage surgery group (combined group) and 18 patients in the limb salvage surgery alone group (surgery group). The primary endpoint was progression-free survival (PFS); secondary endpoints included objective response rate, disease control rate, overall survival (OS), and adverse events (AEs). Therapeutic efficacy was evaluated by response evaluation criteria in solid tumors 1.1, and AEs were graded by common terminology criteria for adverse events v4.0. The median PFS in the combined group was 4.8 months (95% confidence interval: 3.5-7.1 months), significantly longer than that in the surgery group (2.8 months, P < .05). The objective response rate and disease control rate in the combined group were 39.29% and 67.86%, respectively, which were numerically higher than those in the surgery group (16.67% and 38.89%). Common AEs in the combined group included anorexia, leukopenia, and elevated transaminases, with significantly higher incidence than in the surgery group (P < .05); hypothyroidism was more common in the surgery group (P < .05). Anlotinib combined with limb salvage therapy shows favorable efficacy in prolonging PFS and improving disease control in chemotherapy-refractory osteosarcoma patients, with manageable adverse reactions. It may be a viable option for such patients.