Efficacy and safety analysis of vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) in the treatment of osteosarcoma: a systematic review and meta-analysis

Osteosarcoma is a rare and aggressive bone cancer, with targeted therapy using VEGFR-TKIs (Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitors) emerging as a promising treatment option. This meta-analysis evaluated the efficacy and safety of VEGFR-TKIs in osteosarcoma treatment, analyzing studies from PubMed, Embase, Web of Science, and Cochrane databases until 18 September 2023, involving 14 trials with 447 patients. Results indicated that monotherapy with VEGFR-TKIs had an objective response rate(ORR) of 16% (95% CI = 9–24%) and a disease control rate(DCR) of 65% (95% CI = 57–73%). The average progression-free survival(PFS) was 4.27 months(95% CI = 3.21–5.34), with overall survival(OS) at 9.26 months(95% CI = 7.75–10.77). Combined treatments led to an ORR of 7% (95% CI = 2–12%) and a DCR of 71% (95% CI = 54–88%), with PFS of 5.62 months(95% CI = 3.57–7.74) and OS of 11.84 months(95% CI = 9.26–14.43). Treatment-related adverse events occurred in 83% (95% CI = 74–92%), with severe events in 32% (95% CI = 3–61%). In conclusion, VEGFR-TKIs demonstrate effectiveness and tolerability in osteosarcoma treatment, providing significant disease control and survival advantages despite notable adverse event risks. PROSPERO (CRD42024579648)