What is your preferred next line of therapy for a fit patient with unresectable, refractory osteosarcoma who has progressed after MAP, local radiation, and IE?

1. Regorafenib is fine to try. Pazopanib has activity too. I give more pazopanib than regorafenib, so I usually reach for pazopanib first.
2. If your patient progressed right through MAP then there is no reason to go back. But if your patient had primary MAP and now, some time later, has progression, yo...

Cabozantinib also showed activity per CABONE trial. Compares favorably to other TKIs.