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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2020.1337    [Accepted]
Real-World Clinical Outcomes and Prognostic Factors for Patients with Advanced Angiosarcoma who Received Systemic Treatment
Changhee Park1, Miso Kim1,2, Yoonjin Kwak3, Kyung Chul Moon3, Se Hyun Kim4, Bhumsuk Keam1,2, Yu Jung Kim4, Tae Min Kim1,2, Dong-Wan Kim1,2
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Cancer Research Institute, Seoul National University, Seoul, Korea
3Department of Pathology, Seoul National University Hospital, Seoul, Korea
4Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence  Miso Kim ,Tel: 82-2-2072-4035, Fax: 82-2-2072-7379, Email: misokim@snu.ac.kr
Received: December 21, 2020;  Accepted: January 30, 2021.  Published online: February 1, 2021.
ABSTRACT
Purpose
Angiosarcoma is a highly aggressive mesenchymal tumor. Although systemic chemotherapy is often considered for the inoperable or metastatic angiosarcoma, the outcome of such treatment is unsatisfactory and poorly delineated.
Materials and Methods
We reviewed electronic medical records of 75 patients with angiosarcoma who were treated with systemic chemotherapy for inoperable or metastatic disease. Patients were classified as having liver involvement if they had either primary or metastatic hepatic lesions.
Results
Among the patients evaluated, 51 patients were male (68%) and 24 patients (32%) had primary cutaneous angiosarcoma. Liver involvement was present in 28 patients (37.3%). A total of 59 patients received first-line weekly paclitaxel (wPac) and showed an objective response rate (ORR) of 23.7% (n=14), a median progression free survival (mPFS) of 4.0 months (95% confidence interval [CI] 3.0–6.1), and a median overall survival (mOS) of 10.2 months (95% CI 7.0–14.6). Among patients without liver involvement, patients receiving wPac (n=35) had significantly prolonged mPFS (5.8 vs. 3.2 months, respectively, p=0.014) with a tendency for prolonged mOS (13.8 vs. 11.6 months, respectively, p=0.13) than those receiving other regimens (n=12). A total of 24 patients received second- or later-line pazopanib monotherapy and showed an ORR of 16.7% (n=4), a mPFS of 2.4 months (95% CI 1.8–4.3) and a mOS of 5.4 months (95% CI 3.5–NA).
Conclusion
Treatment with first-line wPac and later-line pazopanib seems to provide survival benefit, especially for patients with advanced angiosarcoma without liver involvement.
Key words: Angiosarcoma, Paclitaxel, Pazopanib, Prognosis
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