patient will receive Apatinib 250mg tablet by mouth, bid.

Sarcoma

patients will receive Apatinib 250mg tablet by mouth, bid.

Apatinib monotherapy

Ruijin Hospital Shanghai Jiao Tong University School of Medicine

BIOmarker Driven Trial of VEGFR2 Inhibitor in Advanced Sarcoma

A Biomarker Driven, Open Label, Phase II Study of VEGFR2 Inhibitor Apatinib in Patients With Recurrent or Refractory Advanced Bone and Soft Tissue Sarcoma

The proportion of patients that are progression-free according to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)

The proportion of patients with negative biomarker that are progression-free according to RECIST 1.1

The difference of PFS between biomarker positive and biomarker negative sub-cohorts with log-rank test

Correlation of KDR 604 AA，AG，GG genotype with the incidence of pulmonary lesion cavitation or pneumothorax among all comers

Correlation of KDR 604 AA，AG，GG genotype with the incidence of hair depigmentation among all comers

Correlation of KDR 604 AA，AG，GG genotype with progression free survival according to RECIST 1.1 among all comers

The occurrence of each adverse events(AEs), severe AEs(SAEs) and death according the CTCAE_5.0

Correlation of CSF1R (rs10079250) genotype with the incidence of wound complications among all comers

Correlation of PDGFRα (rs35597368) genotype with the incidence of hand foot skin reaction among all comers

to correlate the incidence of targeted therapy related AEs （pulmonary lesion cavitation, pneumothorax, hair depigmentation) with the PFS

The PFS for each subgroups in terms of clinicopathological characteristics (age, gender, histological type, solitary or multiple metastases, unilateral or bilateral metastases, early or late metastases, calcifying or non-calcifying lesions, with or without lesion cavitation, with or without AEs [especially pneumothorax, hand-foot skin reactions, hair depigmentation], etc

To explore the molecular basis underlying the difference of biomarker positive and negative sub-cohorts using next generation sequencing

to compare the growth pattern/ distribution of pulmonary versus extrapulmonary lesion at baseline and at disease progression between the two sub-cohorts

to compare the diagnostic value of the 1.0 mm versus 5.0 mm CT scan for the radiological evaluation of small lung nodule as tumor recurrence

Weibin Zhang, MD, PhD.

Director of the orthopaedics department

Ruijin Hospital

Radiological Assessment of tumor will be independently reviewed by outcome assessor, who is blinded to patient biomarker status

Thoracoscopy with pleurodesis Patients will then undergo standard medical thoracoscopy in the endoscopy center including the use of moderate sedation, prophylactic antibiotics for 1 week and 20F chest tube insertion at the end of the procedure.

Combined thoracoscopy with pleurodesis and pleurx catheter. In the combined procedure group, a PleurxTM tunnelled catheter will be inserted under ultrasound guidance. As this procedure will be done concurrently with thoracoscopy, there is no estimated increase in endoscopy time.

Malignant Pleural Effusions

Talc poudrage and tunneled pleural catheter

pneumothorax/tyrosine

BIOmarker Driven Trial of VEGFR2 Inhibitor in Advanced Sarcoma

A Prospective, Randomized Controlled Trial for a Rapid Pleurodesis Protocol for the Management of Pleural Effusions

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