Chen Xiaochun, Li Xianqin, Zhao Haiying, Qu Jinwen, Li Xiaojuan, Lin Chuan, Yuan Zhiping
Department of Oncology (Radiotherapy), The First People's Hospital of Yibin, Yibin, Sichuan, China.
Front Pharmacol. 2025 Jul 30;16:1599496. doi: 10.3389/fphar.2025.1599496. eCollection 2025.
Spinal osteosarcoma is a rare and prognostically poor subtype of osteosarcoma, with limited efficacy from traditional chemoradiotherapy. The potential of targeted therapy combined with immunotherapy requires further exploration.
A 53-year-old female with stage IV thoracic spinal osteosarcoma initially received intensity-modulated radiotherapy (total dose of 45 Gy in 15 fractions) and AP chemotherapy (doxorubicin 60 mg/m + cisplatin 100 mg/m). Treatment was discontinued due to grade 4 myelosuppression and sepsis. Subsequently, concurrent combination therapy with anlotinib (12 mg daily for 14 days followed by a 7-day rest) and penpulimab (200 mg intravenously every 3 weeks) was initiated. Penpulimab was administered regularly for 2 years before discontinuation, while anlotinib was reduced to 10 mg daily due to grade 2 hand-foot syndrome and continued thereafter. Post-treatment, the patient achieved significant pain relief, restored self-care capacity, and stable disease (SD) with a progression-free survival (PFS) exceeding 33 months.
This case demonstrates that sequential molecular targeted therapy and immunotherapy following chemoradiation can yield remarkable clinical outcomes, offering a novel therapeutic option for advanced spinal osteosarcoma. However, interindividual variations in treatment response underscore the need for future research to identify predictive biomarkers for patient stratification.
脊柱骨肉瘤是骨肉瘤中一种罕见且预后较差的亚型，传统放化疗疗效有限。靶向治疗联合免疫治疗的潜力有待进一步探索。
一名53岁的IV期胸椎骨肉瘤女性患者最初接受了调强放疗（15次分割，总剂量45 Gy）和AP化疗（阿霉素60 mg/m + 顺铂100 mg/m）。由于4级骨髓抑制和败血症，治疗中断。随后，开始使用安罗替尼（每日12 mg，连用14天，然后休息7天）和派安普利单抗（每3周静脉注射200 mg）进行联合治疗。派安普利单抗在停药前规律使用2年，而安罗替尼因2级手足综合征减至每日10 mg并持续使用。治疗后，患者疼痛明显缓解，恢复了自理能力，疾病稳定（SD），无进展生存期（PFS）超过33个月。
该病例表明，放化疗后序贯分子靶向治疗和免疫治疗可产生显著的临床效果，为晚期脊柱骨肉瘤提供了一种新的治疗选择。然而，个体治疗反应的差异强调了未来研究确定预测生物标志物以进行患者分层的必要性。
