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Outcomes of Systemic Therapy for Patients with Metastatic Angiosarcoma.

ABSTRACT: BACKGROUND:Angiosarcomas (AS) are rare tumors of vascular origin with a variable behavior and overall poor prognosis. We sought to assess the outcomes of patients treated for metastatic disease. METHODS:We performed a retrospective analysis of 119 patients treated for metastatic AS. Outcomes and efficacy measurements of the first and subsequent lines of treatment were analyzed. RESULTS:Median age was 61 years, and the most frequent primary sites were chest wall/breast (31%), viscera (22%) and head/neck (20%). Seventy-three (61%) and 46 (39%) patients received ? 2 and ? 3 lines of therapy, respectively. The most commonly used agents included taxanes and anthracyclines. Median overall survival was 12.1 months. Median times to tumor progression were 3.5 months for first line, 3.7 months for second line and 2.7 months for third line. Among 48 patients evaluable per RECIST, the overall response rate to first line was 30% and <10% in subsequent lines. Doxorubicin, liposomal doxorubicin and taxanes resulted in similar response rates and survival, and there was no apparent benefit for combination chemotherapy. CONCLUSION:Despite reasonable response rates in the first-line setting, benefit from systemic therapy is short-lived in metastatic AS, and outcomes are poor. Doxorubicin, liposomal doxorubicin and taxanes are reasonable and appropriate choices for monotherapy.

SUBMITTER: D'Angelo SP

PROVIDER: S-EPMC5587158 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Outcomes of Systemic Therapy for Patients with Metastatic Angiosarcoma.

D'Angelo Sandra P SP Munhoz Rodrigo R RR Kuk Deborah D Landa Johnathan J Hartley Eliza W EW Bonafede Michael M Dickson Mark A MA Gounder Mrinal M Keohan Mary L ML Crago Aimee M AM Antonescu Cristina R CR Tap William D WD

Oncology 20150603 4

<h4>Background</h4>Angiosarcomas (AS) are rare tumors of vascular origin with a variable behavior and overall poor prognosis. We sought to assess the outcomes of patients treated for metastatic disease.<h4>Methods</h4>We performed a retrospective analysis of 119 patients treated for metastatic AS. Outcomes and efficacy measurements of the first and subsequent lines of treatment were analyzed.<h4>Results</h4>Median age was 61 years, and the most frequent primary sites were chest wall/breast (31%) ...[more]

PMID: 26043723

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Project description:ContextClinical applications of genomic assessment of thyroid cancers are rapidly evolving.Objectives, design, and settingWe studied tumor samples from patients with imminently threatening and rare thyroid cancers to identify genomic alterations that might correlate with outcomes and/or be productively therapeutically targetable.Patient contextProgressive and metastatic, and/or rare, thyroid cancers were studied, 2012 to 2016, at Mayo Clinic sites.InterventionThe intervention was Foundation One tumor interrogation.Main outcome measuresMain outcome measures included genomic alterations, patient characteristics, and overall survival.ResultsSamples from 55 patients were evaluated: 20 anaplastic thyroid cancers (ATCs) (36%), 25 radioactive iodine-refractory differentiated thyroid cancers (DTCs)/poorly differentiated thyroid cancers (PDTCs) (45%; 14 papillary thyroid cancer [PTCs], 6 PDTCs, 5 Hürthle cell cancers), 8 medullary thyroid cancers (MTCs) (15%), and 2 others (a spindle epithelial tumor with thymus-like differentiation, and a primary thyroid sarcoma). Overall, 72% of DTCs, 79% of ATCs, and 75% of MTCs were deemed to have potentially productively targetable alterations. The most commonly encountered mutation was of TERT promoter (56% of DTCs, 68% of ATCs)-but this is not presently targetable. Targetable BRAFV600E mutations were found in 40% of DTCs/PDTCs (83% of PTCs) and 32% of ATCs; of MTCs, 75% had targetable RET mutations, and 25% HRAS mutations. Of patient tumors with nonmutated BRAFV600E, 53% of DTC/PDTCs and 69% of ATCs had other potentially productively targetable mutations. Genomic alterations in our series of poor prognosis metastatic DTC/PDTCs also closely resembled those seen in ATC.ConclusionsWhereas genomic interrogation of favorable prognosis thyroid cancer seems ill advised, potentially productively targetable mutations were demonstrated in the majority of tumors from patients with metastatic thyroid cancers requiring systemic therapy, suggesting a rationale for the selective application of this technology.

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Outcomes of Systemic Therapy for Patients with Metastatic Angiosarcoma.

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Outcomes of Systemic Therapy for Patients with Metastatic Angiosarcoma.

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