Neoadjuvant chemotherapy for angiosarcoma – pro
For stage II-III disease that can be resected with acceptable functional outcomes, the NCCN also recommends preoperative radiation therapy (category 1) or preoperative chemoradiation or chemotherapy (category 2B). Response to preoperative chemotherapy is only 40-50%, with the most active regimens, and toxicity is significant. Consequently, specialists reserve preoperative chemotherapy for patients with high-grade lesions. The regimen is continued in those patients who respond with tumor shrinkage after two to three courses of multiagent chemotherapy after tumor resection.
The NCCN lists the following agents as having activity against angiosarcoma:
• Paclitaxel
• Docetaxel
• Vinorelbine
• Sorafenib
• Sunitinib
• Bevacizumab
It also all other systemic therapy options as per Soft Tissue Sarcoma subtypes, and there NCCN also does not list pegylated paclitaxel.
*** [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
Hirata T, Yonemori K, Ando M, et al. Efficacy of taxane regimens in patients with metastatic angiosarcoma. Eur J Dermatol. 2011; 21(4):539-545.