Two patients (patient 1, a 63-year-old female; patient 2, a 22-year-old male) were treated with anlotinib for lung adenocarcinoma and synovial sarcoma, respectively. Patient 1 developed cough, expectoration, and dyspnea after 8 cycles of anlotinib treatment (12 mg orally once daily, 2 weeks of treatment and 1 week of withdrawal as a treatment cycle). Spontaneous pneumothorax was diagnosed by chest CT. The spontaneous pneumothorax was considered to be related to anlotinib. Then the drug was stopped. After thoracic cavity closed drainage therapy, the patient′s dyspnea was relieved. Due to the progress of the disease, the patient received reduced-dose anlotinib treatment (10 mg/d, with the same usage as before). Spontaneous pneumothorax recurred in the first cycle. Anlotinib treatment was terminated and the symptomatic treatments including thoracic cavity closed drainage, expectorant, anti-infection, and nutritional support were given. Ten days later, chest X-ray examination showed that pneumothorax was cured. Patient 2 developed spontaneous pneumothorax (found by chest CT examination) after 9 cycles of treatment with anlotinib (12 mg/d, with the same usage as that in patient 1). But the patient had no obvious discomfort and continued to use anlotinib under close monitoring of respiratory status.

Two patients (patient 1, a 63-year-old female; patient 2, a 22-year-old male) were treated with anlotinib for lung adenocarcinoma and synovial sarcoma, respectively. Patient 1 developed cough, expectoration, and dyspnea after 8 cycles of anlotinib treatment (12 mg orally once daily, 2 weeks of treatment and 1 week of withdrawal as a treatment cycle). Spontaneous pneumothorax was diagnosed by chest CT. The spontaneous pneumothorax was considered to be related to anlotinib. Then the drug was stopped. After thoracic cavity closed drainage therapy, the patient′s dyspnea was relieved. Due to the progress of the disease, the patient received reduced-dose anlotinib treatment (10 mg/d, with the same usage as before). Spontaneous pneumothorax recurred in the first cycle. Anlotinib treatment was terminated and the symptomatic treatments including thoracic cavity closed drainage, expectorant, anti-infection, and nutritional support were given. Ten days later, chest X-ray examination showed that pneumothorax was cured. Patient 2 developed spontaneous pneumothorax (found by chest CT examination) after 9 cycles of treatment with anlotinib (12 mg/d, with the same usage as that in patient 1). But the patient had no obvious discomfort and continued to use anlotinib under close monitoring of respiratory status.