Angiosarcoma

Section editor
	Elizabeth J. Davis, MD Vanderbilt University Nashville, TN

3 regimens on this page 3 variants on this page

Note: this page contains regimens specific to angiosarcoma.

Guidelines

ESMO

• Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. (2014) PubMed

NCCN

• NCCN Guidelines - Soft Tissue Sarcoma

All lines of therapy

Bevacizumab monotherapy

Regimen

Study	Dates of enrollment	Evidence
Agulnik et al. 2012 (NU 04S1)	2005-08 to 2011-04	Phase 2

Targeted therapy

• Bevacizumab (Avastin) 15 mg/kg IV once on day 1

21-day cycles

References

1. NU 04S1: Agulnik M, Yarber JL, Okuno SH, von Mehren M, Jovanovic BD, Brockstein BE, Evens AM, Benjamin RS. An open-label, multicenter, phase II study of bevacizumab for the treatment of angiosarcoma and epithelioid hemangioendotheliomas. Ann Oncol. 2013 Jan;24(1):257-63. Epub 2012 Aug 21. link to original article contains dosing details in manuscript PubMed Clinical Trial Registry

Paclitaxel monotherapy

Regimen

Study	Evidence
Penel et al. 2008 (ANGIOTAX)	Phase 2

Chemotherapy

• Paclitaxel (Taxol) 80 mg/m² IV over 60 minutes once per day on days 1, 8, 15

Supportive therapy

• Dexamethasone (Decadron) 8 mg IV once per day on days 1, 8, 15, prior to paclitaxel
• Cimetidine (Tagamet) 200 mg IV once per day on days 1, 8, 15, prior to paclitaxel
• Dexchlorpheniramine (Polaramine) 5 mg IV once per day on days 1, 8, 15, prior to paclitaxel
• "Standard antiemetics (mainly Metoclopramide (Reglan)) were prescribed as clinically indicated by the treating physician"

28-day cycle for 6 cycles

References

1. ANGIOTAX: Penel N, Bui BN, Bay JO, Cupissol D, Ray-Coquard I, Piperno-Neumann S, Kerbrat P, Fournier C, Taieb S, Jimenez M, Isambert N, Peyrade F, Chevreau C, Bompas E, Brain EG, Blay JY. Phase II trial of weekly paclitaxel for unresectable angiosarcoma: the ANGIOTAX Study. J Clin Oncol. 2008 Nov 10;26(32):5269-74. Epub 2008 Sep 22. link to original article contains dosing details in manuscript PubMed

Pazopanib monotherapy

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Jones et al. 2022 (TAPPAS)	2017-2019	Phase 3 (C)	Pazopanib & Carotuximab	Did not meet primary endpoint of PFS

Note: to our knowledge, this regimen was not tested as an experimental arm in an RCT in this context, prior to becoming a standard comparator arm.

Targeted therapy

• Pazopanib (Votrient) 800 mg PO once per day

Continued indefinitely

References

1. TAPPAS: Jones RL, Ravi V, Brohl AS, Chawla S, Ganjoo KN, Italiano A, Attia S, Burgess MA, Thornton K, Cranmer LD, Cheang MCU, Liu L, Robertson L, Adams B, Theuer C, Maki RG. Efficacy and Safety of TRC105 Plus Pazopanib vs Pazopanib Alone for Treatment of Patients With Advanced Angiosarcoma: A Randomized Clinical Trial. JAMA Oncol. 2022 May 1;8(5):740-747. link to original article link to PMC article PubMed Clinical Trial Registry