The effect of ifosfamide, epirubicin, and recombinant human endostatin therapy on a cardiac angiosarcoma

Abstract

RationaleCardiac angiosarcoma is a rare malignant tumor, for which only surgery has been proven to be effective to date. Currently there are no reports as to whether a postoperative regimen of ifosfamide, epirubicin, and recombinant human endostatin is effective.Patient concernThe patient presented to us with chest pain and dyspnea.DiagnosisEnhanced computerized tomography (CT) and positron emission tomography–computerized tomography (PET-CT) suggested pericarditis and an atrial perforation, but malignancy was suspected, so the patient underwent an operation to resect the tumor and repair. Pathology of the tumor reseccted at operation showed the tumor to be an angiosarcoma.InterventionAfter the surgery, the patient was stared on a paclitaxel chemotherapy regimen (135 mg/m2 once every 3 weeks). However, 2 cycles later, pulmonary and hepatic metastases were found. Chemotherapy was then changed to ifosfamide, epirubicin (ifosfamide 2000 mg/m2 days 1–3, epirubicin 70 mg/m2 days 1–2) and recombinant human endostatin (7.5 mg/m2 days 1–14) in 3 weekly cycles.OutcomeThree cycles later, follow-up showed that chemotherapy had delayed progression of the pulmonary metastases, but that the hepatic node was still growing. The patient has now survived 8 months post surgery and is still on follow-up.LessonsThis case shows us that operation on late stage cardiac angiosarcomas can alleviate a patient's symptoms; postoperative paclitaxel monotherapy was insufficient and ifosfamide and epirubicin plus recombinant human endostatin has a limited effect on late stage cardiac angiosarcoma. Studies with a larger sample size are needed for verification of these findings.

Case Report: Two cases of advanced primary cardiac angiosarcoma treated with anlotinib and a retrospective analysis of the literature

“…Although this study did not find any advantages of combining gemcitabine with docetaxel as a first-line treatment option (18), it does offer new treatment possibilities for patients with cardiac dysfunction or PCA. Due to the cumulative cardiac toxicity of doxorubicin and cyclophosphamide, the current treatment options for cardiac angiosarcoma mainly involve combining doxorubicin and cyclophosphamide with paclitaxel, docetaxel, or gemcitabine (19)(20)(21)(22)(23). However, the median OS for late-stage PCA patients does not surpass 8 months.…”

Advancements in the Application of the Fenton Reaction in the Cancer Microenvironment

“…This combined approach exerts a dual attack on tumor cells through localized heating via photothermal effects and the generation of oxygen radicals through Fenton-like reactions, thereby enhancing the treatment efficacy and reducing side effects. Consequently, the strategy of utilizing photothermal nanoparticles to catalyze Fenton-like reactions has gained significant attention in recent years [ 84 , 85 ].…”

(Cardiac tamponade as severe manifestation of angiosarcoma)

“…6 Jedinou potenciálně kurabilní metodou je radikální chirurgická resekce, na kterou v indikovaných případech navazuje systémová léčba. 11 Izolovaná systémová léčba a radioterapie jsou pouze paliativní zákroky určené pro inoperabilní pacienty. 4 V posledních letech, patrně v důsledku rozšíření a lepší dostupnosti zobrazovacích metod, incidence srdečních tumorů stoupá.…”