- Author: Belen Carsi, MD, PhD, FRCS; Chief Editor: Dirk M Elston, MD more...
The goals of pharmacotherapy are to reduce morbidity, prevent complications, and eradicate the cancer.
Inhibit cell growth and proliferation.
A cytotoxic anthracycline antibiotic isolated from Streptomyces peucetius var. caesius. These drugs are structurally similar to tetracycline and interfere with DNA production by the cell. All cells can be affected, but rapidly producing cells are damaged. Active against many cancers and has been in use for decades. A clear orange-red powder or liquid only administered IV. Binds DNA and inhibits nucleic acid synthesis. Also a powerful iron chelator and iron-doxorubicin complex, induces production of free radicals that can destroy DNA and cancer cells.
Functional properties of a drug can be substantially affected by liposomal encapsulation. Liposomes used in different drug products can vary in their chemical and physical properties. These differences can substantially affect functional properties among liposomal drug products.
May continue treatment for as long as patient shows progress, shows no evidence of cardiotoxicity, and continues to tolerate treatment; PPE, stomatitis, or hematological toxicity may require doses to be delayed or reduced. Minimum of 4 courses recommended.
An alkylating agent. Inhibits DNA and protein synthesis and, thus, cell-proliferation by causing DNA cross-linking and denaturation of double helix.
Cytidine analog. Metabolized intracellularly to active nucleotide. Inhibits ribonucleotide reductase and competes with deoxycytidine triphosphate for incorporation into DNA. Cell-cycle specific for S phase. Indicated as first-line treatment for locally advanced (nonresectable Stage II or Stage III) or metastatic (Stage IV) pancreatic adenocarcinoma. Indicated for patients previously treated with 5-FU.
Young RJ, Brown NJ, Reed MW, Hughes D, Woll PJ. Angiosarcoma. Lancet Oncol. 2010 Oct. 11(10):983-91. [Medline].
Scow JS, Reynolds CA, Degnim AC, Petersen IA, Jakub JW, Boughey JC. Primary and secondary angiosarcoma of the breast: the Mayo Clinic experience. J Surg Oncol. 2010 Apr 1. 101(5):401-7. [Medline].
Babarovic E, Zamolo G, Mustac E, Strcic M. High grade angiosarcoma arising in fibroadenoma. Diagn Pathol. 2011 Dec 20. 6(1):125. [Medline].
Sturgis EM, Potter BO. Sarcomas of the head and neck region. Curr Opin Oncol. 2003 May. 15(3):239-52. [Medline].
Soft Tissue Tumors. Enzinger FM, Weiss SW, eds. Soft Tissue Tumors. 3rd ed. St. Louis, Mo: Mosby; 1995. 648-77.
Toro JR, Travis LB, Wu HJ, Zhu K, Fletcher CD, Devesa SS. Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978-2001: An analysis of 26,758 cases. Int J Cancer. 2006 Dec 15. 119(12):2922-30. [Medline].
Adami H, Hunter D, Trichopoulos D, eds. Textbook of Cancer Epidemiology. 2nd ed. Oxford University Press; 2008.
Lezama-del Valle P, Gerald WL, Tsai J, et al. Malignant vascular tumors in young patients. Cancer. 1998 Oct 15. 83(8):1634-9. [Medline].
Mark RJ, Poen JC, Tran LM, Fu YS, Juillard GF. Angiosarcoma. A report of 67 patients and a review of the literature. Cancer. 1996 Jun 1. 77(11):2400-6. [Medline].
Schottenfeld D, Fraumeni J, eds. Cancer. Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006. 763-786/959-974.
Meis-Kindblom JM, Kindblom LG. Angiosarcoma of soft tissue: a study of 80 cases. Am J Surg Pathol. 1998 Jun. 22(6):683-97. [Medline].
Lahat G, Dhuka AR, Hallevi H, Xiao L, Zou C, Smith KD, et al. Angiosarcoma: clinical and molecular insights. Ann Surg. 2010 Jun. 251(6):1098-106. [Medline].
DeVita VT Jr, Hellman S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology. 8th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2008.
Virtanen A, Pukkala E, Auvinen A. Angiosarcoma after radiotherapy: a cohort study of 332 163 Finnish cancer patients. The British Journal of Cancer. Jul 2007. 97:115. [Medline].
Patton KT, Deyrup AT, Weiss SW. Atypical vascular lesions after surgery and radiation of the breast: a clinicopathologic study of 32 cases analyzing histologic heterogeneity and association with angiosarcoma. Am J Surg Pathol. 2008 Jun. 32(6):943-50. [Medline].
Huang J, Mackillop WJ. Increased risk of soft tissue sarcoma after radiotherapy in women with breast carcinoma. Cancer. 2001. Jul 1;92(1):172-80. [Medline].
USA: National Cancer Institute (NCI); 2000-2004. The Surveillance, Epidemiology, and End Results (SEER) Program. Available at http://seer.cancer.gov/.
Wenger DE, Wold LE. Malignant vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol. 2000 Nov. 29(11):619-31. [Medline].
Morgan MB, Swann M, Somach S, et al. Cutaneous angiosarcoma: a case series with prognostic correlation. J Am Acad Dermatol. 2004 Jun. 50(6):867-74. [Medline].
Mullamitha SA, Ton NC, Parker GJ, Jackson A, Julyan PJ, Roberts C, et al. Phase I evaluation of a fully human anti-alphav integrin monoclonal antibody (CNTO 95) in patients with advanced solid tumors. Clin Cancer Res. Apr 2007. 13(7):2128-35. [Medline].
[Guideline] NCCN. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Soft Tissue Sarcoma. Available at https://www.nccn.org/professionals/physician_gls/pdf/sarcoma.pdf. Version 2.2016; Accessed: June 1, 2016.
Ray-Coquard I, Italiano A, Bompas E, Le Cesne A, Robin YM, et al. Sorafenib for patients with advanced angiosarcoma: a phase II Trial from the French Sarcoma Group (GSF/GETO). Oncologist. 2012. 17(2):260-6. [Medline]. [Full Text].
Ravi V, Sanford EM, Wang WL, Ross JS, Ramesh N, Futreal A, et al. Antitumor Response of VEGFR2- and VEGFR3-Amplified Angiosarcoma to Pazopanib. J Natl Compr Canc Netw. 2016 May. 14 (5):499-502. [Medline].
Budd GT. Management of Angiosarcoma. Curr Oncol Rep. 2002. 4(6):515-519. [Medline].
Pasquier E, André N, Street J, Chougule A, Rekhi B, Ghosh J, et al. Effective Management of Advanced Angiosarcoma by the Synergistic Combination of Propranolol and Vinblastine-based Metronomic Chemotherapy: A Bench to Bedside Study. EBioMedicine. 2016 Apr. 6:87-95. [Medline]. [Full Text].
Skubitz KM, Haddad PA. Paclitaxel and pegylated-liposomal doxorubicin are both active in angiosarcoma. Cancer. 2005 Jul 15. 104(2):361-6. [Medline].
Vogt T, Hafner C, Bross K, et al. Antiangiogenetic therapy with pioglitazone, rofecoxib, and metronomic trofosfamidein patients with advanced malignant vascular tumors. Cancer. 2003 Nov 15. 98(10):2251-6. [Medline].
Liekens S, Verbeken E, De Clercq E, Neyts J. Potent inhibition of hemangiosarcoma development in mice by cidofovir. Int J Cancer. 2001 Apr 15. 92(2):161-7. [Medline].