Comparison of doxorubicin and weekly paclitaxel efficacy in metastatic angiosarcomas

Abstract

BACKGROUND: Data regarding the role of anthracyclines and taxanes as first-line treatments of metastatic angiosarcoma are limited. METHODS: Records of 117 metastatic angiosarcoma patients who were treated with either doxorubicin or weekly paclitaxel were reviewed. RESULTS: Seventy-five patients (64%) were treated with weekly paclitaxel and 42 (36%) with single-agent doxorubicin. Patients in the weekly paclitaxel group were older and more frequently had angiosarcomas arising from the skin. In the doxorubicin group, 34 patients were evaluable for response: 2 (6%) had complete response, 8 (23.5%) had partial response, 10 (29.5%) had stable disease, and 14 (41%) had progressive disease. In the weekly paclitaxel group, 68 patients were evaluable for response: 9 (13%) had complete response, 27 (40%) had partial response, 20 (29.5%) had stable disease, and 12 (17.5%) had progressive disease. Objective responses to weekly paclitaxel were more frequent in cutaneous angiosarcomas, whereas tumor location did not impact response to doxorubicin. Median progression-free survival (PFS) was 4.9 months (95% confidence interval [95% CI], 3.9-6.0 months). Median overall survival (OS) was 8.5 months (95% CI, 6.4-10.7 months). On multivariate analysis, ECOG performance status (PS) was the sole independent factor associated with PFS and OS. CONCLU-SIONS: First-line single-agent doxorubicin and weekly paclitaxel seem to have similar efficacy in metastatic angiosarcomas. Cutaneous angiosarcomas respond favorably to weekly paclitaxel. Best supportive care should be considered in patients with poor PS. Cancer 2012;118:3330-

Cutaneous versus Non-Cutaneous Angiosarcoma: Clinicopathologic Features and Treatment Outcomes in 60 Patients at a Single Asian Cancer Centre

“…This finding could either reflect the negative impact of microscopic residual disease, or the propensity of more extensive (and thus prognostically poorer tumours) to be unamenable to complete surgical extirpation. Palliative chemotherapy with either doxorubicin or paclitaxel has been reported to confer superior outcomes for metastatic AS in previously reported series [29,31]; we were unable to discern such an effect in our series.…”

Hepatic Angiosarcoma with Dyskeratosis Congenita

“…Some clinical studies of angiosarcoma have recently shown that single-agent doxorubicin and weekly paclitaxel-, gemcitabine-and doxorubicin-based regimens deserve consideration (11,14), while bevacizumab, sorafenib and pazopanib are potential target drugs (10,15,16). However, angiosarcomas are heterogeneous.…”

Vascular-targeted agents for the treatment of angiosarcoma

“…The only prospective phase II study of taxane for advanced disease demonstrated responses in 5/30 (17%), though two were deemed a pathological complete response [103]. A retrospective analysis comparing the response of metastatic angiosarcoma to doxorubicin with the response to weekly paclitaxel suggested similar efficacy [104].…”

“…Angiosarcoma response to paclitaxel has not been directly compared with doxorubicin in clinical trials, but a retrospective analysis suggested similar overall response rates [104]. There has been particular interest in paclitaxel as a chemotherapy option for the treatment of angiosarcoma.…”