Prolonged response to sorafenib in a patient with refractory metastatic osteosarcoma and a somatic PDGFRA D846V mutation

Pediatr Blood Cancer. 2019 Jan;66(1):e27493. doi: 10.1002/pbc.27493. Epub 2018 Oct 14.

Abstract

Outcome for patients with metastatic or recurrent/refractory osteosarcoma remains poor. Responses to sorafenib, a multikinase inhibitor, have been seen in recurrent/refractory osteosarcoma, although specific biomarkers of response have not been described. We report a partial response in a 7-year-old with refractory osteosarcoma treated with sorafenib 200 mg twice daily. Toxicities included Common Terminology Criteria for Adverse Events Grade 2 skin toxicities and growth suppression. After 51 months of therapy, he suffered a recurrence. Tumor sequencing later revealed a PDGFRA D846V mutation that was not identified in the relapse specimen. This case demonstrates prolonged partial response to sorafenib and provides a potential biomarker for response.

Keywords: osteosarcoma; platelet-derived growth factor receptor (PDGFR); sorafenib.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Biomarkers, Tumor / genetics*
  • Bone Neoplasms / drug therapy*
  • Bone Neoplasms / genetics
  • Bone Neoplasms / secondary
  • Child
  • Drug Resistance, Neoplasm*
  • Humans
  • Male
  • Mutation*
  • Osteosarcoma / drug therapy*
  • Osteosarcoma / genetics
  • Osteosarcoma / pathology
  • Prognosis
  • Receptor, Platelet-Derived Growth Factor alpha / genetics*
  • Salvage Therapy
  • Sorafenib / therapeutic use*

Substances

  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Sorafenib
  • Receptor, Platelet-Derived Growth Factor alpha