Paclitaxel Given Once Per Week With or Without Bevacizumab in Patients With Advanced Angiosarcoma: A Randomized Phase II Trial

Ray‐Coquard, Isabelle; Dômont, Julien; Tresch-Bruneel, Emmanuelle; Bompas, Emmanuelle; Cassier, Philippe; Mir, Olivier; Piperno‐Neumann, Sophie; Italiano, Antoîne; Chevreau, Christine; Cupissol, Didier; Bertucci, François; Bay, Jacques‐Olivier; Collard, Olivier; Sâada-Bouzid, Esma; Isambert, Nicolás; Delcambre, Corinne; Clisant, Stéphanie; Cesne, Axel Le; Blay, Jean‐Yves; Penel, Nicolas

doi:10.1200/jco.2015.60.8505

Cited by 157 publications

(125 citation statements)

References 20 publications

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“…Addition of bevacizumab to taxane-based chemotherapy was studied in randomized phase II trial of Ray-Coquard et al [23]. Patients were treated with paclitaxel weekly (90 mg/m 2 ) or combination of paclitaxel (90 mg/m 2 ) weekly and bevacizumab (10 mg/kg biweekly).…”

Section: Discussionmentioning

confidence: 99%

Primary Angiosarcoma of the Spleen: Rare Diagnosis with Atypical Clinical Course

Kohutek

Badik

Bystricky

2016

Case Reports in Oncological Medicine

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Primary angiosarcoma of the spleen is a rare diagnosis with poor prognosis. Morphologically, it demonstrates conventional blood vessel differentiation. We present a case of 65-year-old female who underwent radical splenectomy for primary angiosarcoma of the spleen. After three-year disease-free interval, she was diagnosed with bone-only metastatic disease. Palliative radiotherapy and bisphosphonates kept her disease reasonably stable for another four years. After development of lung metastases, six cycles of single agent doxorubicin kept her progression-free for six years. Upon further progression in lungs, thirteen years after original diagnosis, lung biopsy confirmed metastatic splenic angiosarcoma in the lungs. She started weekly paclitaxel chemotherapy. Although splenic angiosarcoma generally carries grave prognosis, some patients may enjoy prolonged periods of disease stabilization. Durable benefit can be achieved in some patients with multimodality management. We review the literature focusing on systemic treatment for this rare tumor.

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Section: Discussionmentioning

confidence: 99%

Primary Angiosarcoma of the Spleen: Rare Diagnosis with Atypical Clinical Course

Kohutek

Badik

Bystricky

2016

Case Reports in Oncological Medicine

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“…Two phase II studies of chemotherapy in advanced angiosarcoma have been carried out by the French Sarcoma Group [27,31]. The ANGIOTAX study was a single arm phase II study of weekly paclitaxel as first-line treatment in 30 patients with angiosarcoma [31].…”

Section: Angiosarcomamentioning

confidence: 99%

“…The schedule was active and well tolerated, but eventual outcomes were still poor with a median TTP of 4 months and median OS of 8 months. A subsequent randomized phase II study investigated the addition of bevacizumab to paclitaxel in the first-line (2/3 of patients) and nonfirst-line setting in 52 patients [27]. The addition of bevacizumab increased toxicity substantially but did not improve outcomes, although interestingly the outcomes of the entire patient cohort were better than in the previous study, or case series, with median PFS of 6.6 months and median OS of 19.5 months on the paclitaxel arm versus 15.9 months for the paclitaxel and bevacizumab arm.…”

Section: Angiosarcomamentioning

confidence: 99%

“…It is a heterogeneous group, with distinct subtypes, including superficial (particularly scalp), visceral, or radiation-induced (often breast), with evidence of better treatment outcomes for superficial disease [24,25,27] and radiation-induced disease [27]. Although doxorubicinbased chemotherapy has been the mainstay of firstline treatment, more recently evidence has been emerging, mostly from retrospective case series, of activity of paclitaxel [24][25][26][28][29][30] and liposomal doxorubicin [24,30] in the first-line setting.…”

Section: Angiosarcomamentioning

confidence: 99%

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First-line treatment in advanced or metastatic disease: one size fits all or adapted to specific histiotypes?

Seddon

2016

Current Opinion in Oncology

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“…The combination of bevacizumab with doxorubicin in a phase II study in unselected STS subtypes failed to surpass efficacy levels expected for doxorubicin alone, with a safety signal that suggested an increase in cardiac toxicity [46]. Optimism for bevacizumab in STS of blood vessel origin was quelled by a randomised phase II trial that failed to demonstrate incremental efficacy from the addition of bevacizumab to standard paclitaxel chemotherapy [47]. …”

Section: Recent Phase III Studies That Failed To Improve On Standard mentioning

confidence: 99%

Phase III Soft Tissue Sarcoma Trials: Success or Failure?

Lee

Pollack

Huang

et al. 2017

Curr. Treat. Options in Oncol.

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Opinion statementTwo recently reported phase III randomised control trials (RCTs) have resulted in the registration of two new systemic therapies for advanced soft tissue sarcoma. Both of these trials’ designs were informed by phase II data that guided the selection of sensitive STS diagnoses, enabling the demonstration of benefit in certain subtypes. A number of other phase III trials reported in the last 18 months have seemingly fit into a recurrent pattern of failure—promising efficacy signals in earlier phase studies being lost in the survival follow-up of large, highly heterogeneous cohorts. Greater effort is needed to identify histological and molecularly defined subgroups associated with differential treatment response in order to avoid the tremendous disappointment and loss of resources associated with a failed phase III trial. Additionally, improvements in available treatment of advanced STS have underpinned a prolongation in overall survival (OS). Consequently, surrogate efficacy endpoints are of increasing importance to STS drug trials. Whilst progression-free survival (PFS) should arguably replace overall survival as the primary endpoint of choice in first-line studies, more work is required to provide definitive validation of surrogacy, as well as developing more sophisticated techniques of assessing radiological response and expanding the inclusion of quality-of-life-related endpoints.

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Paclitaxel Given Once Per Week With or Without Bevacizumab in Patients With Advanced Angiosarcoma: A Randomized Phase II Trial

Abstract: The primary objective was met in both treatment arms. However, the present data do not support additional clinical investigation of combined paclitaxel/bevacizumab for the treatment of advanced AS.

Cited by 157 publications

References 20 publications

Primary Angiosarcoma of the Spleen: Rare Diagnosis with Atypical Clinical Course

Primary Angiosarcoma of the Spleen: Rare Diagnosis with Atypical Clinical Course

First-line treatment in advanced or metastatic disease: one size fits all or adapted to specific histiotypes?

Phase III Soft Tissue Sarcoma Trials: Success or Failure?

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