Large nose angiosarcoma treated effectively with oral cyclophosphamide combined with propranolol

Daguzé, J.; Saint‐Jean, M.; Dréno, Brigitte

doi:10.1111/jdv.14528

Cited by 15 publications

(13 citation statements)

References 9 publications

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“…The beta adrenergic receptor (β-AR) antagonist, propranolol is a promising agent for the treatment of human angiosarcoma, where its use has increased overall patient survival when combined with chemotherapy. [212][213][214][215][216][217][218] Among these studies, Pasquier et al 218 propranolol will be added to standard of care surgery and doxorubicin chemotherapy for dogs with splenic hemangiosarcoma and no obvious evidence of metastatic disease. Dogs will receive a dose escalation of propranolol after splenectomy and before the first of five cycles of doxorubicin chemotherapy given every 2 to 3 weeks followed by propranolol-containing maintenance therapy.…”

Section: Propranolol As a Modifier Of Sarcoma Cell Metabolismmentioning

confidence: 99%

“…The beta adrenergic receptor (β‐AR) antagonist, propranolol is a promising agent for the treatment of human angiosarcoma, where its use has increased overall patient survival when combined with chemotherapy . Among these studies, Pasquier et al combined oral propranolol with metronomic chemotherapy in seven patients with advanced angiosarcomas for up to 12 months, followed by propranolol‐containing maintenance therapy.…”

Section: Targeting Cancer Metabolismmentioning

confidence: 99%

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Emerging therapeutic approaches for canine sarcomas: Pushing the boundaries beyond the conventional

Borgatti

Dickerson

Lawrence

2019

Vet Comparative Oncology

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Sarcomas represent a group of genomically chaotic, highly heterogenous tumours of mesenchymal origin with variable mutational load. Conventional therapy with surgery and radiation therapy is effective for managing small, low‐grade sarcomas and remains the standard therapeutic approach. For advanced, high‐grade, recurrent, or metastatic sarcomas, systemic chemotherapy provides minimal benefit, therefore, there is a drive to develop novel approaches. The discovery of “Coley's toxins” in the 19th century, and their use to stimulate the immune system supported the application of unconventional therapies for the treatment of sarcomas. While promising, this initial work was abandoned and treatment paradigm and disease course of sarcomas was largely unchanged for several decades. Exciting new therapies are currently changing treatment algorithms for advanced carcinomas and melanomas, and similar approaches are being applied to advance the field of sarcoma research. Recent discoveries in subtype‐specific cancer biology and the identification of distinct molecular targets have led to the development of promising targeted strategies with remarkable potential to change the landscape of sarcoma therapy in dogs. The purpose of this review article is to describe the current standard of care and limitations as well as emerging approaches for sarcoma therapy that span many of the most active paradigms in oncologic research, including immunotherapies, checkpoint inhibitors, and drugs capable of cellular metabolic reprogramming.

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Section: Propranolol As a Modifier Of Sarcoma Cell Metabolismmentioning

confidence: 99%

Section: Targeting Cancer Metabolismmentioning

confidence: 99%

Emerging therapeutic approaches for canine sarcomas: Pushing the boundaries beyond the conventional

Borgatti

Dickerson

Lawrence

2019

Vet Comparative Oncology

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“… 79 Case reports combining propranolol combined with metronomic cyclophosphamide in angiosarcoma suggest promising results that warrant further investigation. 80 , 81 The optimal dose of propranolol for angiosarcoma is not currently known. A dose finding study is currently underway in France investigating increasing dosing of pro-pranolol combined with a stable dose of cyclophosphamide (NCT02732678).…”

Section: Treatment Of Ihmentioning

confidence: 99%

Propranolol for the treatment of vascular sarcomas

Wagner¹,

Cranmer²,

Loggers³

et al. 2018

JEP

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Vascular sarcomas are abnormal proliferations of endothelial cells. They range from benign hemangioma to aggressive angiosarcoma, and are characterized by dysregulated angiogenic signaling. Propranolol is a β-adrenergic receptor inhibitor that has demonstrated clinical efficacy in benign infantile hemangioma, and is now being used experimentally for more aggressive vascular sarcomas and other cancers. In this review, we discuss the use of propranolol in targeting these receptors in vascular tumors and other cancers.

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“…The dose of propranolol in combination therapy varied between 80 mg and 120 mg per day. [19][20][21][22][23][24] In one case, there was a response after 1 week of propranolol monotherapy 40 mg two times per day. 22 These doses of propranolol are much lower than the standard maintenance dose of 160-320 mg daily for patients with hypertension.…”

mentioning

confidence: 99%

PropAngio study protocol: a neoadjuvant trial on the efficacy of propranolol monotherapy in cutaneous angiosarcoma—a proof of principle study

et al. 2020

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IntroductionAngiosarcoma is a rare and aggressive malignancy with a high metastatic potential and recurrence rate. Despite optimal treatment with surgery, with or without radiation, the prognosis remains poor and, therefore, new treatment strategies are warranted. Recently, propranolol has effectively been repurposed for the treatment of infantile haemangioma. Propranolol is a β3-sparing antagonist of the β-adrenergic receptor. In infantile haemangioma, the β1, β2 and β3 receptors are highly expressed. Angiosarcoma has several similarities with haemangioma, including its high β-adrenergic receptor expression and the supposedly important role of vascular endothelial growth factor in malignant growth. As a result, propranolol has been administered small scale in individual angiosarcoma cases with promising results. The precise effect of propranolol, however, is not yet established.Methods and analysisThe goal of this neoadjuvant window of opportunity study is to prospectively evaluate the activity of propranolol monotherapy in patients with cutaneous angiosarcoma. The neoadjuvant setting provides a good opportunity to rapidly evaluate both the clinical response and histological response, without a significant delay in standard anticancer treatment. Fourteen patients with primary, recurrent or metastatic cutaneous angiosarcoma will be included. Propranolol will be administered orally in an escalating dose during 3–6 weeks, before the initiation of standard treatment. The primary endpoint is clinical response according to Response Evaluation Criteria in Solid Tumours, as measured on consecutive coloured photographs or CT/MRI. The histological response will be determined as secondary endpoint, comparing the difference in proliferation index before and after propranolol by measuring the change in immunohistochemistry staining of Ki-67. The study will be considered positive when at least three patients have a response to propranolol.Ethics and disseminationEthical approval was obtained from the Medical Ethical Committee of the Netherlands Cancer Institute. Independent of the outcome, results of this study will be shared and submitted for publication in an international peer-reviewed journal.Trial registration numberNL8118; registry through the Netherlands Trial Register.

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Large nose angiosarcoma treated effectively with oral cyclophosphamide combined with propranolol

Cited by 15 publications

References 9 publications

Emerging therapeutic approaches for canine sarcomas: Pushing the boundaries beyond the conventional

Emerging therapeutic approaches for canine sarcomas: Pushing the boundaries beyond the conventional

Propranolol for the treatment of vascular sarcomas

PropAngio study protocol: a neoadjuvant trial on the efficacy of propranolol monotherapy in cutaneous angiosarcoma—a proof of principle study

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