Abstract: Objective To analyze the characteristics of adverse reactions in the treatment of advanced sarcomas with apatinib. Methods One case of ADRs in a patient with advanced myxofibrosarcoma was summarized and the relevant literature was reviewed. Results Apatinib has been shown to prolong the progression-free survival of patients with advanced sarcomas after failure of standard multimodality therapies. In this case, advanced myxofibrosarcoma was treated with multiple lines and then with apatinib, with a progression-free survival of 5 months. In the course of treatment, the patient suffered from hemoptysis and arrhythmia that were considered to have been caused by adverse drug reactions. Arrhythmia was corrected two weeks after drug withdrawal, and incomplete intestinal obstruction occurred in this patient at the later stage. The dosage of apatinib was reduced, and postoperative intestinal obstruction was gradually ameliorated. Then, the patient suffered from III thrombocytopenia, so severe bone marrow suppression was considered. A series of other adverse reactions also occurred so that the usage and dosage of apatinib were adjusted dynamically, and to good effect. Conclusion The clinical use of apatinib against advanced sarcomas should be monitored more vigorously. Quick and accurate diagnosis of the related symptoms and targeted treatment plans are critical to the safety of patients.

Key words: apatinib, myxofibrosarcoma, adverse reactions, myelosuppression