Olaratumab, a human IgG1 monoclonal antibody, has received accelerated approval from the US Food and Drug Administration (FDA), and conditional marketing authorization by the european Medicines Agency's (eMA) accelerated assessment program, for metastatic soft tissue sarcoma. This is a heterogeneous group of diseases with several subtypes, and the current standard of care since the past few decades has been primarily doxorubicin. Olaratumab is an antagonist of platelet-derived growth factor receptor alpha (PDGFRα) that prevents the binding of PDGF ligands to this receptor, consequently inhibiting subsequent dimerization of the receptor and downstream signal transduction, thereby inhibiting carcinogenesis. In Phase 1 and Phase 2 clinical trials, olaratumab demonstrated acceptable safety profile including lack of cardiac toxicity or immunogenicity, with most common adverse effects being nausea, fatigue, infusion-related reactions, and neutropenia. encouragingly, patients who were administered olaratumab in combination with doxorubicin received an overall survival benefit of 11.8 months as compared to doxorubicin alone. The Phase 3 trial of olaratumab is ongoing and a pediatric Phase 1 trial is also underway. Future studies may help to stratify the target population and leverage the power of precision medicine to benefit patients through tailor-made olaratumab or olaratumab/doxorubicin regimens and the use of potential companion diagnostics to optimize and personalize therapy. The "financial toxicity" of olaratumab is also discussed in light of the rising costs of cancer care and the associated burden to patients, families, and caregivers.Keywords: olaratumab; orphan drug; cancer; sarcoma; PDGFR; monoclonal antibody; pharmacokinetics; pharmacology; precision medicine; financial toxicity Citation: Nair S, Iyer A, vijay v, Bandlamudi S, Llerena A. Pharmacokinetics and systems pharmacology of monoclonal antibody olaratumab for inoperable soft tissue sarcoma. Adv Mod Oncol Res 2017; 3(3): 114-125 http://dx.doi.