Preoperative radiotherapy and bevacizumab for angiosarcoma of the head and neck: Two case studies

Koontz, Bridget F.; Miles, Edward F.; Rubio, Mary Ann D.; Madden, John F.; Fisher, Samuel R.; Scher, Richard L.; Brizel, David M.

doi:10.1002/hed.20674

Cited by 87 publications

(77 citation statements)

References 31 publications

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“…Recently, bevacizumab, a recombinant humanised antibody against vascular endothelial growth factor (VEGF), has also emerged as a promising strategy, since VEGF is overexpressed in approximately 80% of human angiosarcomas. Koontz et al [20] reported that one of two patients with nasal angiosarcomas achieved complete response when treated with bevacizumab and radiotherapy. Further studies are needed to investigate the role of chemotherapy, rIL-2 and bevacizumab for angiosarcoma of the scalp and face.…”

Section: Angiosarcoma Of the Scalp And Facementioning

confidence: 99%

Treatment and prognosis of angiosarcoma of the scalp and face: a retrospective analysis of 48 patients

Ogawa

Takahashi²,

Asato³

et al. 2012

The British Journal of Radiology

104

123

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Objective: The objective of this study was to retrospectively analyse the treatment results of clinically localised angiosarcoma of the scalp and face. Methods: The records of 48 patients who were treated between 1987 and 2009 were reviewed. single modality or a combination of surgery, radiotherapy, chemotherapy and immunotherapy were administered. The median follow-up of all 48 patients was 13.7 months (range 2.5-105.9 months). Results: At the time of analysis, 45 of 48 patients (93.8%) had disease recurrences, and the lung was the most frequent site for recurrence (37 patients). In multivariate analysis, performance status (PS) and number of tumours were significant predictors of lungmetastasis-free (LMF) rate. For patients with multifocal tumours, chemotherapy use significantly decreased the LMF rate (p50.0072). The 2-year actuarial overall survival (OS), progression-free survival and local control rates in all 48 patients were 22.1%, 10.7% and 46.3%, respectively. In multivariate analysis, PS, number of tumours, surgery and radiotherapy were significant prognostic factors for OS. Patients treated with both surgery and radiotherapy (2-year OS: 45.8%) had a significantly more favourable OS (p,0.0001) than patients treated with either surgery or radiotherapy (2-year OS: 11.1%) and patients treated with neither surgery nor radiotherapy (2-year OS: 0%). Conclusions: Our results indicated that PS and number of tumours were significant predictors for developing lung metastases. Our results also indicated that PS, number of tumours, surgery use and radiotherapy use were independent prognostic factors for OS. Multimodal treatments including surgery and radiotherapy were effective in improving OS for patients with these tumours. Advances in knowledge: Multimodal treatments including surgery and radiotherapy are effective in improving overall survival for patients with angiosarcoma of the scalp and face.

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Section: Angiosarcoma Of the Scalp And Facementioning

confidence: 99%

Treatment and prognosis of angiosarcoma of the scalp and face: a retrospective analysis of 48 patients

Ogawa

Takahashi²,

Asato³

et al. 2012

The British Journal of Radiology

104

123

View full text Add to dashboard Cite

show abstract

“…A phase II trial concluded that bevacizumab is an effective and well-tolerated single-agent treatment for metastatic or locally advanced angiosarcoma (20). Several case reports demonstrated that combination therapy with bevacizumab and chemotherapy or radiotherapy may improve quality of life and survival in patients with metastatic angiosarcoma (21)(22)(23)(24)(25). In addition, another VEGF inhibitor, pazopanib, may prolong the PFS of metastatic non-adipocytic soft-tissue sarcoma after previous chemotherapy (26), particularly when used as maintenance therapy for PCA (16).…”

Section: Discussionmentioning

confidence: 99%

Comprehensive treatment of unresectable cardiac angiosarcoma: A case report and review of literature

Wang

Shi

Yang

et al. 2017

Molecular and Clinical Oncology

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Abstract. Cardiac angiosarcoma is a rare but lethal tumor that is difficult to diagnose and treat, due to its rapid local relapse and high incidence of systemic metastasis. The prognosis of cardiac angiosarcoma is dismal, with a mean life expectancy of only a few months. We herein report a case of unresectable angiosarcoma arising from the right atrium. The patient received first-line chemotherapy with weekly paclitaxel, and second-line therapy with vinorelbine and bevacizumab upon disease progression. The progression-free survival was 6 months and the overall survival was 7 months. The patient eventually succumbed to respiratory failure. A study of the present case and a review of the relevant literature suggest that treatment decisions for unresectable locally advanced or metastatic cardiac angiosarcoma are difficult, as the published literature on this disease mainly consists of case reports without sufficient data. Therefore, further clinical trials specific to the treatment of unresectable cardiac angiosarcoma are warranted.

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“…[52][53][54][55] Many of these treatment modalities have severe negative side effects, particularly in children. Therefore, it would be important to develop a less invasive and more targeted therapy for lesions that are amenable to local treatment, such as cutaneous hemangioma.…”

Section: Rapamycin Delivered Systemically or Topically Reduces The mentioning

confidence: 99%

Vascular tumors have increased p70 S6-kinase activation and are inhibited by topical rapamycin

Gerald²,

Perruzzi³

et al. 2013

Laboratory Investigation

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Vascular tumors are endothelial cell neoplasms whose cellular and molecular mechanisms, leading to tumor formation, are poorly understood, and current therapies have limited efficacy with significant side effects. We have investigated mechanistic (mammalian) target of rapamycin (mTOR) signaling in benign and malignant vascular tumors, and the effects of mTOR kinase inhibitor as a potential therapy for these lesions. Human vascular tumors (infantile hemangioma and angiosarcoma) were analyzed by immunohistochemical stains and western blot for the phosphorylation of p70 S6-kinase (S6K) and S6 ribosomal protein (S6), which are activated downstream of mTOR complex-1 (mTORC1). To assess the function of S6K, tumor cells with genetic knockdown of S6K were analyzed for cell proliferation and migration. The effects of topical rapamycin, an mTOR inhibitor, on mTORC1 and mTOR complex-2 (mTORC2) activities, as well as on tumor growth and migration, were determined. Vascular tumors showed increased activation of S6K and S6. Genetic knockdown of S6K resulted in reduced tumor cell proliferation and migration. Rapamycin fully inhibited mTORC1 and partially inhibited mTORC2 activities, including the phosphorylation of Akt (serine 473) and PKCa, in vascular tumor cells. Rapamycin significantly reduced vascular tumor growth in vitro and in vivo. As a potential localized therapy for cutaneous vascular tumors, topically applied rapamycin effectively reduced tumor growth with limited systemic drug absorption. These findings reveal the importance of mTOR signaling pathways in benign and malignant vascular tumors. The mTOR pathway is an important therapeutic target in vascular tumors, and topical mTOR inhibitors may provide an alternative and well-tolerated therapy for the treatment of cutaneous vascular lesions.

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Preoperative radiotherapy and bevacizumab for angiosarcoma of the head and neck: Two case studies

Abstract: The neoadjuvant combination of bevacizumab and radiation therapy is promising and should be further studied in the setting of vascular malignancies.

Cited by 87 publications

References 31 publications

Treatment and prognosis of angiosarcoma of the scalp and face: a retrospective analysis of 48 patients

Treatment and prognosis of angiosarcoma of the scalp and face: a retrospective analysis of 48 patients

Comprehensive treatment of unresectable cardiac angiosarcoma: A case report and review of literature

Vascular tumors have increased p70 S6-kinase activation and are inhibited by topical rapamycin

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